China's bid to ramp up Covid vaccinations hindered by supply shortages

China’s ambitious effort to vaccinate 560 million people -- 40% of its population -- by the end of June is running into a supply shortage, forcing health authorities to extend the intervals between two doses, and leaving some people unable to book their second shots.

The supply bottleneck comes as China’s vaccination roll out accelerates to nearly 5 million doses a day, the fastest in the world, though the proportion of its vast population covered still lags the U.S., Israel and other leading inoculating nations.

While China gets its vaccine supply from domestic manufacturers, thus giving it more control than most countries which are struggling to secure doses, the accelerated pace is pushing the limits of what its homegrown makers can churn out, said people familiar with the matter.

This partly drove a decision at the end of March by China’s National Health Commission to issue guidelines on vaccination that said the interval between the first and second dose can be stretched to as long as eight weeks, said the people, who asked not to be identified as they’re not authorized to speak publicly.

This is over twice as long as the dose interval used during clinical trials of the vaccines made by state-owned China National Biotec Group and Beijing-based Sinovac Biotech Ltd.

Among Western vaccines, dose intervals for mRNA shots range from 21 days to 28 days, while the U.S. Centers for Disease Control and Prevention recommends a maximum of six weeks. In the U.K., AstraZeneca Plc.’s vaccine is advised to be administered with an interval of between four to 12 weeks.

The moves underscore the mammoth effort ahead of China, which has virtually eliminated the pathogen domestically and yet risks falling behind other countries -- particularly geopolitical rivals like the U.S. -- in achieving herd immunity and re-opening its economy and borders. In recent weeks, a hardening propaganda campaign that links vaccination to maintaining China’s global prestige in containing the coronavirus has raised take-up rates considerably, but it’s still vaccinating just five out of every 100 people, compared to 27 in the U.S. and 56 in Israel, according to Bloomberg’s vaccine tracker.

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The National Health Commission did not respond to questions sent by fax.

The supply shortage is being exacerbated by Beijing’s pledge to make its shots a global public good to help end the pandemic. More than 100 million doses have been donated and sold overseas and more will be exported as Chinese makers are on track to be included in the WHO-backed Covax program to provide immunization access to poorer nations.

China has also offered vaccines to the International Olympics Committee for the upcoming Tokyo Games, while carrying out discussions with European countries looking for supply.

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The supply shortage appears to be felt unevenly across China. Beijing, the capital, does not appear to have any supply concerns and has raced ahead with over half of its population dosed. Meanwhile, financial center Shanghai -- whose population is also over 20 million people -- has raised Sinovac dose intervals from 14 to 21 days due to supply concerns, said one of the people. To date, Shanghai has given out only 5.5 million doses.

In southern Guangdong province, China’s manufacturing hub, the local government has selected five key cities of Guangzhou, Shenzhen, Foshan, Dongguan and Zhuhai to prioritize for vaccination while halting new doses in all other cities, said a person familiar with the situation there.

In the central Chinese city of Wuhan, the local CDC branch notified some residential compounds to temporarily suspend vaccinations because shots are running out, said people familiar with the situation there.

Given supply constraints, the 40% vaccination target is a nationwide one and doesn’t mean coverage will be even across places, said one person familiar with authorities’ thinking. Densely populated megacities along the developed eastern part of China are being prioritized for vaccination, while remote, sparsely inhabited western provinces will be further behind in the line.

In recent days, some people have complained on social media platforms that they’ve been unable to book appointments for second shots.

In northeastern Jilin province, resident Wang Yuemei said she’s been told by local officials that she can’t get a vaccination appointment. Some cities in northeastern China are barring people from getting first doses, as their remaining supply will be rationed for those who have already taken a first shot and are waiting for a second, said people familiar with the situation there.

“They said it’s due to the shortage of the vaccine. I’m in a wait-and-see mode because even if I get a first shot, there’s a chance I can’t get the second,” said Wang, 42. “This already happened to one of my family members who has passed his set date for the second shot but is still told to keep waiting.”