SHANGHAI: As China works to raise Covid-19 vaccination rates among its elderly population, authorities are still facing one major hurdle: the lingering fears among many old people that the jab could actually do them harm.
Vaccinating the vulnerable has long been seen as a crucial requirement in China's plans to open up after nearly three years of disruptive and economically damaging zero-COVID restrictions.
China's health authority said on Wednesday that it would aim to improve accessibility and launch targeted programmes in nursing homes and leisure facilities as part of a new vaccination drive among the over-60s.
It also pledged to make renewed efforts to publicise the benefits of vaccination, and persuading the old and vulnerable that it is both safe and effective could be the most challenging part of the campaign.
"Concerns about safety and the lack of effectiveness probably are the major reasons why older adults refuse or delay vaccination," said Florence Zhang, a researcher at the School of Medicine at China's Jinan University, who has conducted studies into vaccine hesitancy among China's elderly.
There was little immediate sign of increased take-up rates at local hospitals and specialist vaccination centres in Shanghai, and many elderly residents were still expressing concern about its health impact.
"If I were fit for vaccination, I would definitely get it," said Cai Shiyu, a 70-year-old retiree. "But I've had a heart stent, and I have heart disease, and high blood pressure: what if something happens?"
A 76-year-old resident named Yang Zhijie concurred.
"Without the vaccination, I already have so many diseases, and after I do it I'm scared the diseases will become more serious."
China has offered vaccinations for the elderly since April 2021, but the take-up rate slowed noticeably this year.
By November, the proportion of people aged 60 and above to be fully vaccinated reached 86.4 per cent barely changing from 85.6 per cent in August. Those who have received a booster jab increased to 68.2 per cent from 67.8 per cent over the period.
The vaccination and booster rates in Japan, by contrast, were both at more than 90%.
Public health experts have sought to explain why the take-up rate in China has been relatively low, with studies indicating that the elderly were deterred not by vaccine scepticism, but by other factors like health, mobility and access.
The National Health Commission said it would take the campaign directly to residents of nursing homes and retirement facilities, though they only account for around 3 per cent of China's elderly population, according to a research paper by Shanghai's Fudan University in September.
The promise to deploy specialist vaccination vehicles and temporary vaccination stations could therefore prove more effective, with China vowing to deliver door-to-door services to those who are disabled or housebound, and to provide staff to make sure they were properly monitored afterwards and treated if anything went wrong.
China has also been slowly rolling out vaccine insurance to reassure those who are worried about dangerous side-effects. A survey of over-60s conducted by the Fudan University researchers showed that 51 per cent of vaccine-hesitant respondents said they would be more likely to get jabbed if more insurance was available.
Ye Weifang, an unvaccinated 83-year old Shanghai resident, told Reuters that she would need to be reassured by her doctor before receiving the jab.
"I look like I'm in good health now, but I have a pretty serious illness," she said. "If the doctor thinks I can get vaccinated, I will do it." --Reuters