Mar 27, 2021 06:18 PM

Why China’s Covid Vaccination Drive Puts the Young Before the Old

Zhang Wenhong
Zhang Wenhong

While many countries have put the elderly first in line for Covid-19 vaccination, such as the U.S. and the U.K., China has prioritized adults aged under 60. Why?

The answer lies in how China’s epidemic situation differs from those countries, medical experts said.

China was the first country to experience a Covid-19 outbreak, but within a few months it effectively contained the virus from spreading and has recorded relatively low numbers of infections since the second quarter of last year.

In a country where there is virtually no Covid-19 epidemic, young people can be vaccinated first to build an immune barrier for the rest of society, Zhang Wenhong, one of China’s top epidemiologists, said in a lecture in Macao on Friday.

“In China … once the risks of young people who go out to socialize and those groups with a high risk of exposure are brought under control, the epidemic will have nowhere to go, because there will be no sources of infection,” Xu Jiru, an immunology professor at Xi’an Jiaotong University, told Caixin.

In contrast, in countries where the disease is still spreading widely, the most vulnerable people should be vaccinated first, otherwise the risk posed by catching Covid-19 far exceeds the risk of negative side effects from vaccination, said Zhang.

“(In those countries) high-risk groups will have severe symptoms and a high fatality rate once they are infected, which can lead to a drain on medical resources,” Xu said. So for them, vaccinating the old first is an emergency measure, she said.

When formulating a vaccination strategy, authorities need to prioritize one of two goals: either slow the spread of the virus or reduce the number of deaths, and either way can protect high-risk groups such as the elderly — the former indirectly while the latter directly, medical professionals said.

China started its Covid-19 immunization campaign late last year. The three-step program (link in Chinese) is scheduled to first vaccinate key groups including the 18-to-59 age group and people with a high risk of exposure such as medical workers, transport workers and customs staff, before moving on to high-risk groups including the elderly who are at risk of developing severe illness if infected, and finally to the population as a whole.

Lately, there have been signs that the world’s most populous country is speeding up its rollout, after concerns were raised that it was moving too slowly.

Vaccine developers are accelerating research, and after they obtain sufficient safety and efficacy data from clinical trials, China will begin inoculating people over 60 “on a large scale,” (link in Chinese) He Qinghua, a health ministry official, said at a press conference on March 31.

Since late February, healthy people over 60 in some regions, including Beijing, Shanghai and the southern island province of Hainan, have been able to get Covid-19 vaccines, according to local health authorities.

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Currently, China’s vaccination program is still at its early stage. As of Friday, about 97 million doses (link in Chinese) of Covid-19 vaccine had been administered, government data show. Under the unlikely scenario that each vaccine recipient has received a single shot, that figure means roughly 7% of the country’s 1.4 billion population would now have some level of immunity against the virus.

To reach herd immunity, China needs to vaccinate at least 80% of its population, Zhang said earlier this month.

Although not everyone is willing to be vaccinated, those who are currently unwilling to get a jab may change their mind as their confidence in the vaccine grows stronger, Zhang said in the Friday lecture.

So far, China has approved five Covid-19 vaccines for public use, including two separately developed by affiliates of state-owned China National Pharmaceutical Group Co. Ltd., one by Sinovac Biotech Ltd., one by CanSino Biologics Inc. (688185.SH), and one jointly developed by the Institute of Microbiology under the state-backed Chinese Academy of Sciences and a subsidiary of Chongqing Zhifei Biological Products Co. Ltd. (300122.SZ).

All of these vaccines except CanSino’s require two to three jabs to achieve full immunity.

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It has been more than a year since the first known case of Covid-19 was detected in the central Chinese city of Wuhan. Currently, the novel coronavirus has infected about 126 million people and claimed more than 2.7 million lives worldwide.

Matthew Walsh contributed to this report.

Contact reporter Lin Jinbing ( and editor Joshua Dummer (

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