People wearing face masks line up to receive the COVID-19 vaccines at a vaccination site in Jiangxia District in Wuhan, central China's Hubei Province, June 9, 2021.Photo: Xinhua

China on Sunday became the first country in the world to have administered one billion doses of COVID-19 vaccines. Such achievement is believed to be a "milestone" but not "surprising" given China's thorough vaccination plan and effective implementation system. 

China has administered more than 1.01 billion doses as of Saturday, according to data released by the National Health Commission on Sunday. The number is about three times that delivered in the US, and almost 40 percent of the 2.5 billion shots given globally, according to data website Our World in Data.   

China kicked off its national vaccination drive in December, 2020. Despite a slow start due to the low willingness among the public to receive the vaccine, given how well the epidemic had been brought under control, the country has witnessed a surge in daily delivered doses since May - more than 10 million per day and sometimes even double that number - following unexpected continuous outbreaks in Northeast China's Liaoning, East China's Anhui and South China's Guangdong provinces. 

The continuous boost in vaccine production and speedy vaccination roll-out in China reflects the government's quick response in both vaccine research and its mass inoculation plan against the outbreak, and is also a result of China's highly efficient governance system, said the experts.

"The milestone represents China not only comes closer to full domestic immune protection, but also makes a great contribution to the global fight against the epidemic," Feng Duojia, president of the China Vaccine Industry Association, told the Global Times. "China's actual supply of vaccines significantly exceeds domestic use, and China continues to offer doses overseas." 

China has provided more than 350 million doses of COVID-19 vaccines to the world, Foreign Ministry spokesperson Zhao Lijian said at a press conference on Wednesday. 

Registration for vaccination will actively continue, given the public's confidence in the government and Chinese vaccines, Feng noted. "Ensuring a vaccination rate of more than 80 percent is no longer a problem. What needs to be solved now is how to ensure an ideal immunity effect after full public vaccination."

In the next step, China should also enhance investment in vaccine research and development to improve the products as well as explore the best vaccination procedure to maximize efficacy, a Beijing-based immunologist told the Global Times on Sunday on condition of anonymity. 

To improve the vaccines so that they can handle virus mutations as well as make them safe for the elderly will be the focus in the next step, the expert said. 

Media reports revealed that since June 10, some places in China have issued notices saying they will give priority to people who are due to accept their second or third shots over those registering for their first shots. 

The expert said that the arrangement is aimed at ensuring those who have had first shots can complete their vaccination procedures in a timely manner and build immunity effectively, which will also help to protect those who have not yet had any shots. 

More than 1 billion vaccine doses administered in Chinese mainland Important milestone

China surpassed threshold of administering 100 million doses of the vaccine on March 27, and the pace of vaccination has been accelerating since then, setting records again later. On May 28, the number of vaccinations in China exceeded 600 million doses, just five days after it achieved 500 million. The high speed has been maintained ever since, moving from 900 million doses on June 14 to reaching 1 billion on June 19, a space of just five days.

If each person received two doses, the rough vaccination rate in China would be around 36 percent currently. If the current rate continues, there is little doubt that vaccination rate will reach 40 percent by the end of June, a target set up at the beginning of the year.

Chen Xi, an assistant professor of public health at Yale University, told the Global Times that China's administration of 1 billion vaccine doses is an important milestone, but he is not surprised that the number has been achieved so quickly, as it fits in well with China's initial goals.

For a country of 1.4 billion people, getting 1 billion doses of vaccine is just the first step in building herd immunity, according to Feng. China is expected to have 70 percent of the target population fully vaccinated by the end of this year and form herd immunity, Feng said.

China's top epidemiologist Zhong Nanshan previously said that to achieve herd immunity, China needs a vaccination rate of 83.3 percent, assuming the vaccine has a protection rate of 70 percent, or at least at an inoculation rate of 72.9 percent if the vaccine is 80 percent effective.

Chinese vaccines have been gradually rolled out to people aged 3-17 years, and a wider demographic and rising inoculation rate in the national immunological spectrum is expected.

Globally, Chinese vaccines are also being approved and used by increasingly more governments. For example, Singapore started to offer Chinese produced Sinovac Biotech COVID-19 vaccines to the public for the first time since Friday. Several private clinics have reported overwhelming demand for the Chinese-made shot, despite already available rival vaccines having far higher efficacy rates, Reuters reported.

Challenges in the next step

Despite taking the absolute leading position in total number of doses administered, China lags behind some other countries in the number of vaccine doses administered per 100 people. 

According to Our World in Data, as of Friday, the number was 68.8 doses per 100 people in China, ranking the seventh highest globally. It is about half of the world's highest 144.57 doses per 100 people in the United Arab Emirates. 

As of the same day, the vaccination rate is 94.5 doses per 100 people in the US. 

But experts said that China would soon catch up given the country's current vaccination speed. According to Our World in Data, China has the second highest number of daily doses administered per 100 people - 1.26 doses - following South Korea's 1.37 doses on June 17.    

Chen expected that the inoculation speed in China may experience a slowdown as it works toward the 80 percent vaccination rate target from the current 40 percent, as is the case in many other countries. But the slowing speed in China will be lower than in other countries, as the risk from neighboring countries and imported infections reinforces people's urgency to get vaccinated. Also, the autumn and winter seasons may again see an upswing in sporadic infections..

Feng said there is no great concern of the vaccine failing as a result of the increasing prevalence of mutated strains worldwide. "In the nearly one-year post-vaccination observation by experts, we did not find an obvious inflection point in its efficacy, which demonstrates a longer duration of vaccine protection."

The current monitoring results did not show that the virus mutations will cause the existing vaccine to fail. Even for the worst case scenario, China has started to prepare vaccines with mutant strains, so that the new vaccine can be used quickly if needed, according to Feng. "It will never be useless to get early shots as they are providing sustained protection for us," he noted.

A booster pin has not been a "must" so far, and its necessity and schedule continue to be studied. But China has already carried out relevant research on booster shots, which means that new immunization strategies can be initiated at any time if needed.

Chen believes that the next step regarding inoculation should focus on bridging the gaps between regions and populations, ensuring the coverage rate of the elderly, patients with underlying diseases and other vulnerable groups, and prepare for a gradual reopening of the border to the world in the future.