With carrot and stick, China presses ahead with Covid vaccinations for elderly

In China’s southern Guangdong province, a teacher was told by her school that she must somehow find four unvaccinated individuals aged 60 or older and get them to take Covid shots to help boost the district’s elderly inoculation rate.

Otherwise, her performance review would be affected.

“But (I) have classes to teach… I can’t just leave my students and go looking for a needle in a haystack,” the teacher, who goes by the name Sherry, told Reuters.

Because some other individuals in her district had been given similar tasks by their employers, Sherry said she had to offer cash incentives from her own pocket to beat the competition to win over the elderly. She said she had spent nearly 1,000 yuan (US$158) in total on two people she managed to get vaccinated.

In the past month, the Omicron variant has dragged the world’s most populous nation into its biggest Covid outbreak since it contained the 2020 Wuhan epidemic, even though the numbers are modest by international standards.

There were over 38,000 local symptomatic cases in March, more than four times the number of infections in the whole of 2021. That number did not include those without symptoms, which China classifies separately.

Nevertheless, China is maintaining a policy of curbing transmissions as soon as they emerge and considers its elderly as a weak link, given their low vaccination rates.

Out of the 264 million people aged over 60, about 20%, had not completed their primary vaccination as of March 25. By comparison, the complete vaccination rate for the 1.41 billion population is around 88%.

Officials say some of the elderly worry about potential post-vaccination reactions or deem the shots unnecessary.

At a nursing home in Beijing, only three of its 43 elderly residents have been vaccinated, said a representative of the institute surnamed Qin.

“None of the family members of any old individuals have voluntarily asked for vaccination,” Qin told Reuters, adding that staffers managed to persuade family members of only half of the residents to agree to vaccinations, despite the surge in Covid infections.

Many in the home are under long-term treatment for existing conditions, and their family members worry about how Covid shots could affect routine medication, Qin said.

“There will be some families who think that (the elderly) are so old, they don’t go out anyway, and are already bedridden, so there’s no need for vaccination.”

Vaccine incentives

China is worried about what happened in Hong Kong, where most deaths in its recent Covid outbreak were the elderly. Beijing has said the flare-up in the former British colony is a lesson the mainland should learn from.

Many grassroots leaders have dispatched people to knock on doors to pitch the idea of vaccination to the elderly, keep a record of those yet unvaccinated and their reasons for being so, hold conversations with them to allay concerns about vaccines, and rigorously update how many doses they are short of targets.

That method, used in China’s mass Covid vaccination drive in 2021, could see renewed momentum as some deadlines near.

The northwestern province of Qinghai said it aims to give over 560,000 individuals aged 60 and above a first dose by the end of April. It said in March that officials will be held accountable for any feet-dragging.

Taoshan, a district in Qitaihe city in Heilongjiang province, said its fight to vaccinate 83.2% of its residents older than 60 by April 1 “must be won”, and it will name and shame people and institutes that have done a poor job.

Many areas have doled out incentives for vaccinations like shopping coupons, free groceries and even cash, some of which target the elderly.

A neighbourhood in Chaoyang district in Beijing in March sent out mobile phone messages to residents saying those aged above 60 will be given 500 yuan (US$79) after receiving their first shot.

Sherry, the Guangdong teacher, said a red hot “local market” had emerged in finding yet-to-be-vaccinated elders. Some of her colleagues had paid elders more than 1,000 yuan per person to get them take the shot, she said.

“It feels so surreal,” she said.