Hospitals in China are reported to be filling up with Covid patients after the country relaxed its lockdown rules.
The government says it will now ramp up its vaccination programme, having immunised relatively few people until now.
What are China’s new Covid rules?
Following mass protests over its controversial “zero Covid” policy, China has dropped mass testing in cities and regions where there have been outbreaks.
People can now stay at home if they have mild Covid symptoms, rather than being sent to a quarantine centre.
Because it has ended its mass testing programme, Chinese authorities no longer have reliable figures for the number of Covid infections.
However, there are anecdotal reports of hospitals filling up with patients.
The World Health Organization (WHO) has asked it to provide specific data on disease severity and hospital admissions.
How many people have been vaccinated in China?
Official figures for November suggest Chinese health authorities have now vaccinated 40% of over-80s with two jabs and a booster.
People in this age range are the most vulnerable to the virus.
This is a big improvement on China’s past performance.
In April 2022, fewer than 50% of people aged between 70 and 79 age had received two jabs and a booster, and fewer than 20% of over-80s.
China is now reported to have set a goal for 90% of its over-80s to receive either the initial two vaccination jabs, or both plus a booster, by the end of January.
However, vaccinations alone may not be enough to halt the surge in Covid cases.
Experts believe that because the Chinese population has been locked down so much, many people have not picked up “hybrid immunity”.
This means they haven’t gained protection both from being vaccinated and from being exposed to the virus through other people.
Why have so few elderly people been vaccinated in China?
When China’s government started rolling out vaccines in late 2020, it prioritised the working-age population.
It did not test its vaccines on many elderly people, and told them it could not say whether they were safe for this age group.
The head of China’s Covid expert panel, Prof Liang Wannian, says that made some people reluctant to get their jabs.
“Many old people have underlying diseases,” he says. “They reckon it won’t be safe to get vaccinated.”
Are China’s Covid vaccines effective?
China has only used domestically-produced vaccines on its citizens: CoronaVac, made by a company called Sinovac, and Sinopharm.
Both use parts of a dead coronavirus to expose the body to Covid and stimulate the immune system to produce virus antibodies.
A US study suggests that Sinovac – the more widely used of the two – is only 66% effective at protecting against Covid infection and 86.3% effective at preventing death.
Both Sinovac and Sinopharm are less effective than the mRNA vaccines made by Pfizer and Moderna which have been widely used in western countries.
These train the immune system to attack the spike protein on the virus – the part of the virus which infects the body’s cells.
They offer 90% protection against severe disease or death.
Which countries use Chinese vaccines?
Since the start of the pandemic, 64 other countries have used Sinopharm and 34 have used Sinovac.
They have been especially popular in Asian countries such as Indonesia, Thailand, Malaysia, Vietnam and the Philippines.
The Chinese vaccines can be stored in a refrigerator between 2 and 8C, while Moderna’s mRNA vaccine needs to be stored at -20C, and Pfizer’s at -70C.
Many developing countries use China’s vaccines because they do not have the facilities to store large amounts of vaccine at such low temperatures.
Why has China not used Western Covid vaccines?
China claims to have made about half of all the world’s Covid vaccine stock.
The government has refused so far to approve Western mRNA vaccines for domestic use. Germany has sent doses of the Pfizer vaccine to China, but they will only be given to foreign residents.
China is believed to be developing its own mRNA vaccine, but has not said when this might be available.
It reportedly asked US company Moderna to give it the technology behind its mRNA vaccine, but the company declined to do so.