Hong Kong: the vaccine paradox

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Since the beginning of 2021, Hong Kong has the incredible privilege of not only having two vaccines available, but also of being able to choose its vaccine. Despite this, we have seen a form of “vaccine paradox”, where the city has one of the most performing vaccines available worldwide, and also the possibility of choosing their vaccine… Yet most healthcare personnel and the large majority of the population are refusing to get inoculated.

An issue with trust

Since the 2019 protests, and with the 2020 crackdown on democracy activists, the Hong Kong government has been affected by a real issue of trust. The implausible or often absurd utterances by many government officials have managed to discredit their words, to the point that even the most reasonable statements are hardly believed nowadays.

Riot police stand guard near the US consulate in Hong Kong on July 4th, 2020.
Hong Kong, China, 04 Jul 2020 Riot police stand guard in front of the US Consulate General in Hong Kong,
to prevent protesters from marching there.

It did not help that in January 2021, the first deliveries of the Pfizer vaccine to Hong Kong were suddenly beset by all sorts of delays, while the Sinovac Chinese vaccine came in quickly after an expedited review of incomplete documentation by the manufacturer.

Where it got more mystifying, was when locals decided that even the Pfizer-BioNtech vaccine was too “dangerous” for them, and decided to massively sit out the vaccine bookings. The involvement of the Chinese firm Fosun Biotech definitely complicated the understanding for anyone not familiar with distribution and licensing deals in the Pharma world.

A stuttering start

The real kick-off of vaccination was on 26 February 2021, when after a long delay, the first Community Vaccination Centres (CVC) for Sinovac came online. Although tepid, the uptake was encouraged by local relays of the DAB, the pro-China establishment party.

Start of the vaccination at Kowloon Bay CVC

After the initial wave of elderly candidates (those were the only ones allowed to get vaccinated, along with a maximum of two accompanying “carers), the bookings remained somehow unstable.

An elderly man and his family takes Pfizer vaccine in Hong Kong
An elderly man and his family take the Pfizer vaccine in Hong Kong.

To try and increase coverage, the Hong Kong Government then opened vaccination to anyone above 30 years. This extension was met with enthusiasm by expats and enlightened locals, and while the bump in registrations was short-lived, it soon ended.

Opening of vaccination for Pfizer

BioNtech stopped for “vials issues”

Then happened the disaster. All of a sudden, the Hong Kong Government suspended all BioNtech vaccinations, because it allegedly found issues with some vials upon defrosting. It took a couple of weeks before a new batch of vaccine was shipped, and this, among others, caused almost one week delay for my second shot (should have been taken after 21 days, was effectively taken later, but can be taken up to 42 days later).

The official version was that defrosting caused some crimping of the vials’ covers, hence

Finally after an “investigation” which bordered the ridiculous, a new batch of vaccines was sent to Hong Kong, allowing thus the resumption of the vaccination program, despite the delays.

A vaccination center for Pfizer in Hong Kong
A vaccination center for Pfizer in Hong Kong.

That’s how, in the middle of April, I finally managed to get my second shot of Pfizer vaccine.

An elderly resident gets vaccinated with Biontech.
An elderly resident gets vaccinated with Biontech.

The vaccine fear

Part of the rejection of the vaccination resides in the mistrust of the authorities as several articles have pointed out. But the very paradox is that Hongkongers have been pretty good at obtaining information autonomously, and without the intervention of the government. There is a wealth of information available online on vaccines, their side effects or the clinical trials that took place (except for Sinovac, but obviously, nobody is obliged to get that vaccine).

The real reason for the rejection, among the protesters milieus, seems to be the desire of not handing over a victory to the Government. Other reasons, among the general public, seems an inordinate fear of vaccines, especially due to their quick development time (I heard that many ladies in childbearing age are scared of being rendered sterile or risking spontaneous abortions if they get vaccinated).This did not improve after two pregnant women happened to lose their baby shortly after a vaccination (without any causal link being demonstrated).

It seems that our modern society has been creating an expectation of invulnerability for people who do not seem to even consider remotely the presence of death. This is probably to link to the other great avoidance of death in the Chinese culture.

Vaccine lottery

To remedy this irrational fear, the HK Government turned to another irrational aspect of HK behavior. It pushed the private sector to organize lotteries, offering free apartments, cash prizes, etc. In fact, beyond personal safety in a city that got a reasonable handle on the epidemic by turning the city into a literal fortress, people have been delaying inoculation, also because they expect some form of reward for it.

It is another form of vaccine paradox, that while the rest of the world is painfully aching for vaccines that are not even available, Hongkongers expect to be paid to take it. But this is also the consequence of a society that took the habit of functioning on a clientelist mode, where quid pro quo is the norm between constituents and their politicians.

This more fundamentally challenges the idea of the 2019-2020 protests, where it was advocated that Hongkongers are politically mature to decide their own political future. The lack of leadership and also the lack of decent political leaders does not plead for the political maturity of Hong Kong.

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