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China’s booster vaccination drive is slowing as medical staff are redirected to carry out mass testing with coronavirus cases rising across the country.

Relatively low vaccination rates will leave tens of millions of Chinese people vulnerable to severe illness if the government’s tough “zero-Covid” policy fails to contain the Omicron variant.

In the final week of March, China administered 770,000 third-dose jabs a day to over 60s following outbreaks in Shanghai and Jilin. But that figure had fallen to 590,000 a day by mid-April, according to data released by the country’s health department.

Jin Dong-yan, a virologist at the University of Hong Kong said the drop-off in daily inoculation rates reflected the deep-seated vaccine hesitancy among China’s elderly. “The last unvaccinated group is always the most difficult to reach out to and convince to take the vaccine,” he said.

If China continues to administer inoculations at this rate, it will take until September until 90 per cent of the elderly population completes the full three-dose vaccination course, according to a Financial Times analysis.

Chinese mainland authorities have resorted to strict lockdown measures to prevent a repeat of scenes in Hong Kong when a surge of Omicron cases in February caused an increase in deaths among its elderly unvaccinated residents.

Beijing announced on Tuesday that almost 20mn residents would have to undergo three rounds of tests by Saturday after 33 cases were reported that day. But some health experts are worried that government policies risked hampering vaccination drives or even enabling community spreading of the virus.

“In Shanghai, medical resources have been reallocated to temporary hospitals and to do PCR tests, which meant vaccinations came to a sudden stop in the city,” said Jin.

Just over 40 per cent of China’s over 60s, or 109mn people, are under-vaccinated, meaning they have had less than three doses of the locally produced Sinovac and Sinopharm jabs required to achieve high levels of protection against Omicron. That figure rises to over 60 per cent in Shanghai.

One Shanghai doctor, who spoke to the Financial Times on condition of anonymity, said that frontline medical personnel were struggling to cope with the increased workload after many staff were redirected to conduct citywide testing.

Chinese officials have implemented localised or citywide mass testing whenever an outbreak has occurred throughout the pandemic. That strategy squashed virus surges, including Delta outbreaks in Shanghai and Xi’an, at the end of 2021.

But the efficacy of that strategy is being re-examined after Shanghai entered its fourth week of a citywide lockdown. There are no indications of when the restrictions on human movement, which have resulted in residents of the country’s most populous city struggling to access food and medical supplies, will end.

“The same measures that worked for Delta do not work for Omicron,” said Jin, explaining that it was “very difficult” to administer contact tracing or conduct epidemiological investigations on the variant owing to its high transmissibility.

Experts have warned that Omicron could be spreading during mass testing drives and many Shanghai residents have refused to comply with testing orders.

Jin said fears of community transmission as Hong Kongers queued for a PCR test were among the main reasons health authorities in the Chinese territory decided against a planned citywide test in March.

But mainland China is sticking to this approach.

The capital is bracing itself for the prospect of a Shanghai-style lockdown. Residents are emptying supermarket shelves after a series of cases emerged over the weekend, prompting concern that Omicron had been spreading for days in the city without detection.

Additional reporting by Xueqiao Wang in Shanghai, Maiqi Ding and Nian Liu in Beijing

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