Over the past week, dozens of county-level governments in at least eight provinces have issued notices warning citizens that they have until the end of July or early August to be fully immunized with two doses.
“Everyone is responsible for preventing and controlling the epidemic, and vaccination starts with me!” said a notice issued by Dingnan County in Jiangxi Province, which is home to around 220,000 people.
Shao Yiming, an epidemiologist with the China Center for Disease Control and Prevention, told state media that since China’s vaccine protection rate is less than 100%, China will need to fully immunize 80-85% of residents, which equates to 1 billion people. the country’s 1.4 total population, in order to meet the December deadline.
With China largely containing the spread of the virus, many residents initially did not see the need to be vaccinated. A history of safety scandals involving national vaccines has also contributed to public reluctance. However, several recent local epidemics, notably in the northern provinces of Anhui and Liaoning, and Guangdong in the south, have fueled fears of infection, prompting a rush to get vaccinated in the affected areas.
The all-out campaign has seen government agents descend on neighborhoods to try to convince people to get vaccinated, with vaccination sites offering perks ranging from vouchers to free groceries and ice cream.
But experts have warned that many residents who have yet to receive a single dose would be harder to reach, especially in rural areas, leading local governments to take more drastic measures to ensure immunity. collective.
“All of these strategies they used to get people to get vaccinated… might not work in this next stage of vaccination efforts,” said Yanzhong Huang, senior researcher for global health at the Council on Foreign Relations.
“Making it mandatory may be the only viable solution to the problem,” he added.
In the first two weeks of July, at least 50 counties in 12 Chinese provinces issued notices warning of heightened measures to encourage unvaccinated citizens to get vaccinated, adding that “not being vaccinated will affect life and the exits”.
To date, notices of new measures have been issued in Sichuan, Fujian, Shaanxi, Jiangsu, Jiangxi, Guangxi, Anhui, Shandong, Hebei, Henan, Zhejiang and Inner Mongolia. .
Most of the areas imposing the measures are relatively small by Chinese standards – the largest is Zaozhuang City in Shandong Province, which has a population of 4.2 million. The first of the measures was announced on July 8, and as of Wednesday, new notices were still posted.
Policies vary widely from location to location – in 33 of the counties, authorities said immunization records will be checked upon entering public facilities, including administrative buildings and health facilities, and citizens who have not received their vaccine will be encouraged to do so. therefore.
But in 19 counties, local governments have explicitly warned that within weeks, unvaccinated citizens could be banned from accessing a wide range of public places and services.
“From July 17, in principle, people who have not been vaccinated (…) are not allowed to enter key places such as inpatient departments of hospitals, nursing homes, schools, libraries, etc., “said a notice posted in Jingyan District in Sichuan. , adding that this would make an exception for those who have a legitimate health reason to avoid the vaccine. The notice also said unvaccinated supermarket workers and market stall owners would be excluded from their jobs.
In a few counties, the measures are even more extreme. In Guangxi, two cities – Guiping and Beiliu – both said students would not be allowed to go to school unless both of their parents were fully vaccinated. After strong opposition on social media, the reviews were removed although it is not clear whether the restrictions will still apply.
And in Tanghe County, Henan Province, state media reported that local government agencies would stop paying employees or workers in state-owned enterprises if they refused to be vaccinated.
Test ball or official pressure?
Likewise, the Australian government has demanded that all elderly caregivers have received at least one injected Covid-19 vaccine by mid-September.
“Unvaccinated people will face various obstacles in living and working under the policy. The only way to avoid these obstacles is to get vaccinated. If it is not a forced vaccination, what can it be? Shen asked.
“Before compulsory vaccination against Covid-19 becomes a legal obligation, there is no legal basis for applying such restrictions,” he added.
“As a local administrative service, it must respect the people, move forward and backward with the people, and build a united front in epidemic prevention,” the editorial said.
To date, the Chinese central government has not officially made vaccination against Covid-19 compulsory. Jin Dongyan, professor of precision medicine at the School of Biomedical Sciences at the University of Hong Kong, said the policies were likely the result of local government officials under extreme pressure to meet Beijing’s vaccination targets.
As part of the top-down administrative structure of the Chinese government, political decrees are often drawn up by the country’s rulers and then left to local authorities to decide how to implement them. Failure to meet political goals could cost local politicians future promotions or even their jobs.
“They have to deliver and they will use any means at their discretion and they will try all the options available,” Jin said.
But Huang, of the Council on Foreign Relations, questioned whether the new policies were the overzealous work of local government officials under pressure to meet vaccination targets, or a trial balloon thrown by the Communist Party in Beijing.
The Chinese government has long tested potentially controversial initiatives at the local level before presenting them at the national level to see how they will be received by citizens, Huang said.
“It may be an initiative of the central government,” he said.
Huang added that if Beijing wanted to ensure that China could maintain herd immunity, it might have to make the vaccine mandatory, whether or not it was a popular measure. “For any vaccine that is less than 80% effective, you need to vaccinate the entire population,” he said. “Just asking people to get vaccinated is not going to do it. “
China has approved the use of five national vaccines – two developed by the state-owned Sinopharm and others by Sinovac, CanSino and Anhui Zhifei – with the majority of the population receiving Sinopharm or Sinovac injections.
So far, trials show that Sinopharm and Sinovac have lower efficacy against Covid-19 than their mRNA counterparts. In Brazilian trials, Sinovac was around 50% effective against symptomatic Covid-19 and 100% effective against serious illness, according to test data submitted to the World Health Organization. The effectiveness of Sinopharm for symptomatic and hospitalized illnesses has been estimated at 79%, according to the WHO.
CNN’s Nectar Gan and Yong Xiong contributed to this report.