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. 2024 Aug 5;22(1):90.
doi: 10.1186/s12961-024-01155-1.

Achilles' heel: elderly COVID-19 vaccination policy in China

Ziru Deng  1 , Karen A Grépin  2
Affiliations

Achilles' heel: elderly COVID-19 vaccination policy in China

Ziru Deng et al. Health Res Policy Syst. .

Abstract

Background: Despite high overall COVID-19 vaccine coverage, the continuously low elderly vaccination rate in mainland China remains a dangerous threat as the country shifts away from its zero-Covid policy. This retrospective study uses the Multiple Streams Framework to examine how macro-level factors may explain poor elderly vaccination outcomes.

Methods: We performed a thematic analysis of qualitative data obtained from 95 official press conferences from October 20, 2020, to February 27, 2023, vaccination-related policy documents, and media coverage, using both inductive and deductive coding approaches.

Results: Our findings suggest that in the problem stream, elderly vaccination was not a "focusing event" during the initial vaccine rollout, resulting in delayed outreach to this population. Additionally, ideologically driven complacency and discrepancies in top-down implementation undermined elderly vaccination in the political stream. In the policy stream, precautious and ambiguous statements, inconsistent policy content, radical shifting media messages, and less age-friendly digital technologies also affected elderly vaccination.

Conclusions: The poor convergence of the three streams led the elderly to be the Achilles' heel of China's COVID-19 containment strategy. Future studies should focus on priority identification, adoption of enforcement measures, and timely and effective policy dissemination. The empirical lessons from China can inform and optimize elderly vaccination policy design and implementation in the post-pandemic era.

Keywords: COVID-19; Elderly vaccination; Multiple streams framework; Policy analysis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Timeline of the major COVID-19 vaccination policies in China
Fig. 2
Fig. 2
COVID-9 vaccination rates of people aged 60 years and above in China. *Elderly vaccination data were obtained from the official NHC website. To account for variation in reporting, this study used a total elderly population of 264 million (aged 60 years and above) to calculate proportions
Fig. 3
Fig. 3
Stages and timeline of mass vaccination rollout
Fig. 4
Fig. 4
Word frequency of the 95 subjects and content of press conferences
See this image and copyright information in PMC

References

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