A Chinese woman receiving the Sinovac Covid-19 coronavirus vaccine in Hangzhou, in China's eastern Zhejiang province, June 20, 2021. Photo: AFP via China OUT / Stringer

China has reportedly inoculated mostly with one shot around 1.2 billion of its 1.3 billion-plus population but a debate is now stirring about next steps as the Delta variant of Covid-19 spreads in the country’s south.

As total vaccinations in China near the size of the country’s population, the southern industrial powerhouse cities of Guangzhou and Shenzhen are still on a wartime footing to contain the spread of the Delta strain.

However, there are divergent views on how best to proceed between the National Health Commission (NHC) and the Chinese National Center for Disease Control.

While China’s nationwide immunization blitz has seen the number of doses administered pass 1.2 billion, according to the NHC’s latest June 29 figures, the commission did not reveal how many have been fully inoculated with two shots. 

Xinhua cited NHC director Ma Xiaowei as saying that more than 100 million shots had been administered every five days since June. Beijing is aiming to rev up its roll-out to almost all residents, with an extra dose of urgency as it counted down to the previously stated end-of-June goal to fully vaccinate 40% and pave the way for herd immunity. 

NHC experts, including Dr Zhang Wenhong, the director of the NHC’s National Infectious Disease Medical Center in Shanghai, said the 40% goal was well within “touching distance,” even though the health authority was yet to release more figures. 

The Beijing-based Caijing magazine, overseen by the state-owned CITIC Group, also cited a senior NHC official in its June issue saying that the top leadership had decreed a 75-80% coverage goal by October.

A woman receives a vaccination at a hospital in Shanghai. Photo: AFP

Hinting at a more mandatory approach to combat vaccine hesitancy, the magazine said for the nation to attain herd immunity before the winter season that almost every Chinese must by then have had two jabs. 

The reports said the NHC could soon seek help from the police and other law enforcement agencies to list, track and prod people to roll up their sleeves, starting first in major cities like Shanghai, where the overall progress reportedly needs a shot in the arm.  

Shanghai’s Municipal Health Commission, meanwhile, has denied any name-and-shame plans to boost vaccine take-up. However, it added that the city’s individual districts would employ different means to boost injections.

Shanghai’s downtown Huangpu, Pudong, Changning and Xuhui districts have started issuing de facto compulsory vaccination orders to all close contacts of confirmed cases as well as anyone living close to designated quarantine facilities.

The city will impose legal repercussions including detention for those who resist vaccination orders, according to the city’s Xinmin Evening News. Most of Shanghai’s 30 million doses administered so far were first shots. The city has a total population of 26 million. 

At the same time, there are signs that supplies may soon be stretched as drugmakers ship more batches to virus-hit Guangzhou and Shenzhen.

Calls are now being made by National CDC experts to prioritize second dose injections over prodding new takers to simply boost the overall total of doses in what they fear could be a misguided numbers game. 

Shao Yiming, a senior researcher with the Chinese CDC, told Xinhua that cities expecting a temporary supply crunch must make better use of remaining stocks to guarantee partially immunized people could receive their second shots.

Otherwise, the efficacy of vaccines would wane significantly if more than 21 days elapsed since the first dose, he said. Shao’s appeal was seen as pushback against the NHC’s universal injection quotas. 

Zhang Hongtao, an associate professor with the University of Pennsylvania’s Medical School and a former immunization planner with Shanghai’s CDC, also warned that people with only one shot would be just as vulnerable to Covid-19 as people with none and there was scientific proof suggesting the correlation of partial vaccination and the heightened risks of more viral mutation producing vaccine-resistant variants. 

The scholar told Asia Times that “real-world data” from Brazil had revealed that a single dose of Sinovac only produced “negligible” levels of antibodies and thus protection of about 15% against the novel coronavirus. But with two jabs, overall efficacy could hit the 50% threshold or higher, in line with the findings from the drug’s final trials. 

This photo taken on February 27, 2021, shows a trolley carrying Pfizer-BioNTech vaccines being transported to a warehouse after being unloaded from a Cathay Pacific cargo plane at Hong Kong International Airport in Hong Kong. Photo: AFP / Jerome Favre
Fosun chairman Guo Guangchang said the company was willing to make efforts to help combat the epidemic. The Shanghai-based conglomerate is the exclusive distributor of BioNTech’s mRNA vaccines in the Greater China Region. But Chinese drug and medical watchdogs are yet to greenlight the drug’s sale in mainland China. Photo: Files

The People’s Daily newspaper has also waded into the debate with commentaries that say priority should be given to those waiting for second doses. It said the NHC should release more data about the level of full vaccination and make recommendations based on solid scientific evidence. 

Last week, the paper also ran an op-ed by a popular science columnist that hailed the outstanding potency of the messenger ribonucleic acid (mRNA) vaccines, the novel drug against Covid-19 most widely taken in the West but not yet available in mainland China. 

The piece called on Chinese health watchdogs to hasten the approval of mRNA shots, like those supplied by German drugmaker BioNTech and America’s Moderna. It noted the latest flare-up of cases in southern China amid a wider take-up of Chinese-made shots had laid bare their mediocre performance in neutralizing more transmissible strains.

The article also warned that without better drugs, China would have to play a drawn-out defensive game and shut its borders as the West starts to reopen. 

The NHC and officials in Guangzhou and Shenzhen previously admitted that several residents were still infected with the Delta strain despite being fully vaccinated.   

Shanghai Fosun Pharma, the exclusive distribution partner of BioNTech in the Greater China Region, applied to import and sell mRNA drugs in mainland China in the first quarter.

But a senior executive of the company told reporters during an annual general meeting in May that he did not expect a quick turnaround from the National Medical Products Administration, even though the drug had “worked its wonder” in the West’s war against the virus. 

Read more: