Weekly dispatch: why is China vaccinating the young first?

So it's happening. The 物业 (property management) of my office building in central Beijing is collecting the names of all those working in the building who would like a shot of China's new Covid-19 vaccine. Although there is no fixed date yet, it seems that after the Spring Festival it should be possible for us all to get vaccinated. It is not yet clear if the shot will be free for foreign citizens, as it is for the Chinese, but in the meantime I have put my name on the list. All of my colleagues have done the same; there is no widespread scepticism about the vaccine's safety here.   

Only a fraction of the Chinese population has currently been vaccinated, but at least in Beijing mass vaccinations are starting to be rolled out. Notices have also appeared in my 小区 (neighbourhood), announcing that vaccinations will be available next week for all long-term residents aged 18 - 59. Yes, here in China the vaccine is being given to the young first. People over 60 are not being offered the vaccine for the time being, in stark contrast to much of the world.

The Sinovac vaccine has apparently only been tested on younger segments of the population, which would currently make it unsafe to administer to older people. This suggests that the Chinese strategy, from the beginning, was to focus on those of working age rather than the elderly. This strategy makes some sense for China, given the situation. The pandemic has been brought under control within the country, and it is unlikely to return with a vengeance, considering the gargantuan efforts made to isolate and contain new outbreaks. The elderly are not at serious risk of infection, so the idea is to focus on vaccinating people who need to go abroad for work or study, those who work in certain professions considered at risk (medical staff, airport staff, those who work in cold storage units, even taxi drivers) and eventually a large number of working-age people. 

All this is understandable and also convenient for me, since it means I am being offered a vaccine far earlier than I would be almost anywhere else. On the other hand, it will be an issue for the many developing countries that are making use of the Chinese vaccine. China's large production capacity, and the fact that the Sinovac vaccine doesn't need to be stored at extremely low temperatures like the Moderna and Pfizer vaccines (-20 and -70 degrees, respectively), but can be stored in a normal refrigerator (as can the Oxford vaccine), makes it an attractive solution for the nations of the "global south". 

At least some of the countries that have bought large quantities of Chinese vaccines, however, are imitating China's strategy of inoculating the young first. Most strikingly, Indonesia has already bought three million Sinovac vaccines, and it is only using them to inoculate people in the 18-59 age range, just like China is doing. This is a surprising choice for Indonesia, the country with one of the worst Covid-19 pandemics in Asia, where the official number of deaths just keeps rising and rising, probably matched by an even higher unofficial death toll. In many cities hospitals are close to collapse, while the government seems to have given up on enforcing strict lockdowns.

The Indonesian health minister has justified this choice by saying that there is not enough data on the safety of the vaccine for older people. Indonesian officials have also pointed to the fact that vaccinating the young will help restart the economy and stop the spread of the virus, but it can be assumed that the lack of tests conducted on the elderly was part of the reason behind this decision. The Turkish government, which has bought millions of vaccines from China, has also announced that people over 65 will not be vaccinated at first "to avoid risks". Turkey also has an ongoing pandemic, in which the elderly are most likely to become casualties. Regardless, countries like Turkey and Indonesia have little choice but to make do with the Chinese vaccine, at a time when the supply of the other vaccines is still so limited that even the EU and the UK are fighting to get their hands on as many of them as they can.

On a personal level, as a foreigner living in China, the strategy of vaccinating young people first makes me wonder when the country's borders will finally open up again. Unlike in Europe and North America, here in China the plan is clearly not to vaccinate those most at risk of dying or getting seriously ill, and then letting everyone else get on with their lives. On the contrary, as long as the elderly are not vaccinated it will be especially important to do everything possible to prevent the pandemic from spreading again. This will mean, among other things, keeping in place the incredibly tough quarantine measures and the restrictions on the entry of foreign citizens. 

I doubt that even getting vaccinated will allow me to enter China from abroad without quarantine (which, from my perspective, would be one of the best reasons to get the shot); it is not certain, after all, that those vaccinated are unable to be infected and then spread the virus, and the Chinese government can accept nothing less than 100% certainty that not a single new case enters the country. This approach is leading to ever stricter measures. Most provinces now require 21 days of quarantine, not 14; Beijing and several other cities have also started requiring all those in quarantine to take anal swabs, because apparently they are more reliable than nose and throat swabs! As cases inevitably slip through the net, leading to new lockdowns of neighbourhoods and even entire cities, the measures taken to keep the virus out become ever more intrusive and grotesque. 

I don't doubt that China will eventually get round to vaccinating most of its population, including its senior citizens. This process might, however, take a couple of years, especially since vaccines are also being exported abroad at the same time. In the meantime, China will continue to be cut off from the world for most intents and purposes.