Elderly people are the most likely group to die severely after infection with the new crown virus, and protecting them is one of the most important purposes of epidemic prevention, and vaccination is the most effective means of protection.
On March 18, 2022, the National Health Commission revealed at the press conference that the proportion of people aged 60 to 69 in China who received one dose of the vaccine was 88.8%, the proportion of two doses was 86.6%, and the proportion of people who completed the third dose of enhanced immunization was only 56.4%; the three figures of the population aged 70 to 79 were 86.1%, 81.7% and 48.4%, respectively; the three figures of the population over 80 years old were 58.8%, 50.7% and 19.7%, respectively.
This means that there are still a large number of elderly people on the mainland, especially those over 80 years old, who are not vaccinated or receive adequate doses of vaccine protection.
Jiao Yahui, director of the Medical Administration Bureau of the National Health Commission, said that according to current statistics, about 65% of the patients with severe covid-19 are over 60 years old. Among older adults classified as severe, 65% are not vaccinated. "This is also why the state advocates that the elderly, especially the elderly, be vaccinated in a timely manner." She said.
According to Hong Kong data, since the fifth wave of the epidemic, the mortality rate of people over 80 years old who have received one dose or no vaccination has reached 12.9%, and the vast majority of the dead are unvaccinated elderly people. Data released by the Jilin Provincial Health Commission shows that in the past wave of epidemics, the average age of severe and critically ill patients was 77 years old, and about 70% of patients had not received a single dose of vaccine.
As for Shanghai, Wu Jinglei, director of the Municipal Health Commission, said that as of April 15, nearly 3.6 million people aged 60 and over in the city had completed the full vaccination of the new crown vaccine, with a vaccination rate of 62%; 2.18 million people had completed enhanced immunization, with a vaccination rate of 38%.
Studies and surveillance have shown that the Opichron variant is still very harmful to the elderly, especially those who are not vaccinated and have chronic underlying diseases. Although vaccination does not completely block the transmission of the virus, it is very effective in preventing severe illness and death.
Because of this, Wu Jinglei suggested that eligible elderly people should be vaccinated as soon as possible after the community is unsealed and the nearby vaccination point is opened, and the vaccination should be strengthened as soon as possible after the full 6 months of vaccination to produce better results.
Worldwide, some countries have higher vaccination rates for older persons, how do they do this? The Paper (www.thepaper.cn) interviewed professionals from a number of representative countries to discuss their practices and experiences.
Vaccination sites in Japan
Japan: From backwards to leading
As the world's most aging society, Japan was once far behind in vaccination.
In July 2021, just seven weeks before the opening of the Tokyo Olympics, only 3.5% of Japan's population was fully vaccinated, when there were fears that the epidemic in Japan was about to break out.
On April 18, according to Japan's NHK television station, 81.3% of Japanese people have been vaccinated with two doses. Of particular concern is that the more elderly the elderly, the higher the vaccination rate: the two-dose vaccination rate for the elderly over 65 years old is 92.56%, 98% for the elderly over 80 years old, and 71.4% for the elderly who have received the third dose.
The Vaccination Working Group of the Health Science Committee of the Ministry of Health, Labor and Welfare of Japan believes that the risk of serious complications and death is higher than that of young people.
Vaccination rates of two doses of vaccine for all ages in Japan
What's surprising is not just the huge shift in data, but more importantly, how did Japan do it? In fact, the Japanese were hesitant about the COVID-19 vaccine. A January 2021 survey revealed that the vast majority of people were skeptical of the COVID-19 vaccine that had just been developed at the time.
Professor Kentaro Iwata, an infectious disease expert at Kobe University in Japan, explained to The Paper the process of Japan's transformation.
"First you have to have a safe and effective vaccine to provide, then there are data to show the effectiveness and safety of the vaccine, so that people have confidence in the protection of the vaccine, and finally, trust in the government and medical institutions." Iwata said.
Iwata said some countries may be less worried about COVID-19 because of the long-term absence of the epidemic and feel that there is no need to take the risk of vaccination. Japan has experienced six waves of outbreaks so far, and many people have suffered and fallen ill, so the willingness to get vaccinated is high.
For many elderly people, the fear of side effects from vaccinations is one of their main concerns. "The Japanese are reassured to see that the vast majority of vaccines given to thousands of people in other countries, including the elderly, are safe. Only a few people have doubts, so most people fight, and in a society like Japan, which advocates conformity, everyone fights, and I fight. Iwata said.
He further explained that for the elderly, it is easier to accept when they see that the elderly in other countries who have not been vaccinated have a high risk of death.
Iwata stressed that vaccines are very important for protecting the elderly in Japan. "In the first few waves of the vaccine, we had a lot of elderly deaths, but now we have very few [elderly deaths], thanks to the role of vaccines." He said.
As vaccination rates have risen, the case fatality rate in Japan has been declining. According to Johns Hopkins University, before mass vaccination, japan's covid-19 confirmed case fatality rate reached as high as 5%, but now it is only 0.1%.
Yasuda Fengjun, a visiting researcher at Ritsumeikan University in Japan and a media person, also told the surging news that compared with Europe and the United States, Japan does not have too many political and religious factors to hinder, which is also one of the reasons for the high vaccination rate. Yasuda's wife is a health worker, and both parents have been vaccinated three times.
"Vaccines were once rare in Japan, but only gradually became abundant, most Japanese people follow the advice of medical professionals to get vaccinated, while in other countries there are not many political and religious obstacles in Japan." Yasuda said.
Looking back at Japan's epidemic prevention for more than two years, Professor Iwata concluded that the vaccine has successfully "decoupled" the relationship between death and the spread of the virus. "Now, you can't completely stop the spread of the virus, the long lockdown is difficult to maintain, you have to be prepared for more frequent outbreaks and the emergence of more new variants in the future, and vaccines are the most important tool against severe illness and death." He said.
Singapore: Hospital government relatives join forces
Since 29 March, Singapore has abolished the requirement to wear masks outdoors. From 1 April, all vaccinated overseas travellers only need to be tested for COVID-19 within 48 hours of departure, and can move freely after entering the country, no longer need to be tested or quarantined.
Singapore's recovery from the Opichron outbreak and its gradual return to normal life are indispensable to the country's extremely high vaccination levels.
Higher vaccination rates protect Singapore's healthcare system. As of 12 April, 94% of people aged 80 and over in Singapore have completed two doses, 96% of people aged 70 to 79 and 97% of people aged 60 to 69. In the past 28 days, there have been about 170 000 new indigenous cases in Singapore, 99.7% of which are asymptomatic or mild symptoms, and only 0.02% need to be treated in the ICU, with a mortality rate of about 0.05%.
According to the Singapore Health Department, there were 802 deaths of the new crown virus in 2021, of which 555 were not fully vaccinated with two doses, accounting for 70% of the deaths.
Two doses of vaccination rates for all ages in Singapore
Professor Paul Anantharajah Tambyah, a prominent infectious disease scientist in Singapore and president of the Asia-Pacific Society of Clinical Microbiology and Infectious Diseases (APSCMI), told The Paper that Singapore has adopted a multi-pronged approach to increase vaccination rates among the elderly.
In response to the concerns and obstacles of vaccination for the elderly, the possible reasons analyzed by the Singapore government include: some people in the media and society have released incorrect vaccine information, and even smeared the vaccine, resulting in misunderstanding among the elderly; many elderly people are usually long-term patients, who are very worried about the side effects of vaccination and whether they can be vaccinated; some medical personnel and family members are more conservative about vaccination, which also affects the enthusiasm of the elderly to vaccinate.
In this regard, Temayyad shared Singapore's experience that the government, medical staff and relatives work together to persuade the elderly to increase vaccination rates: first through a lot of popular science publicity through the media; then with the assistance of local community workers, home visits to persuade and enlighten the elderly, and provide door-to-door vaccination services to facilitate the elderly; and finally, to impose some restrictions on the travel of unvaccinated people to certain public places.
"The government has adopted a 'soft and hard' approach. The soft aspect is the provision of open and transparent information to prove the efficacy and safety of vaccines, coupled with a lot of publicity, in language familiar to the elderly, with officials and public figures they trust. Hard aspects, such as not allowing unvaccinated people to dine in restaurants and not entering shopping malls. Singaporean political observer Tan Kehan told the surging news.
Chen Kehan introduced his personal experience, the government from the database to find the elderly in his home, door-to-door to inquire whether there is an appointment for vaccination, and then launched a private and neighborhood organization to persuade. "Family persuasion also plays an important role, and private clinic doctors are mobilized because they are trusted by patients and so have influence." He said.
Chen Kehan introduced that for those elderly who are sick in bed or inconvenient to move. The government will send medical teams to their homes to vaccinate them. Some of these medical teams are private doctors and nurse volunteers because the government does not have so many resources.
"The whole process takes time, and those who had doubts and saw that the people around them were all right to get vaccinated, and their minds changed." He said.
Europe and the United States: the elderly give priority to playing
According to 2019 data from the United Nations Population Division, the EU has 20.8% of the population aged 65 and over, making it one of the most ageing regions in the world.
At the end of 2020, as the COVID-19 vaccine was approved for marketing in Europe, the European Centre for Disease Control and Prevention (ECDC) emphasized in its guidelines for COVID-19 vaccination strategies that the elderly and nursing home staff, healthcare workers, immunocompromised people and their caregivers should be the priority group to be vaccinated.
Despite differences in implementation details, most EU and North American countries rank older adults in the first echelon of vaccination. Research data from the U.S. Centers for Disease Control and Prevention shows that unvaccinated adults are 11 times more likely to die from COVID-19 than fully vaccinated adults.
Two doses of vaccine and booster vaccination rates for all ages in the UK
As of now, 90 percent of the U.S. population over the age of 65 has received two doses of the vaccine and 61 percent have received a third dose. Vaccination rates for people over the age of 60 in the UK are also over 80%.
Two doses of the U.S. and enhanced vaccination rates for all ages
Chen Zhengming, an epidemiologist at the University of Oxford in the United Kingdom, told the surging news that there are several reasons for the high vaccination rate of the elderly in the United Kingdom: there are highly effective and safe vaccines verified by large-scale clinical trials, especially for the elderly; it is impossible to achieve zero clearance, the epidemic is hidden from time to time, the public is alert and the urgency of vaccination; a large number of publicly published studies confirm the harm of the new crown to the elderly; the support and example of politicians and celebrities, and the appearance of the statement (such as public reports on the vaccination of Queen Elizabeth II of the United Kingdom) Traditionally, there are arrangements for annual influenza vaccinations; a large number of publicity and introduction activities involving credible doctors and scientists; and the elderly are given priority when vaccinating, and vaccination is carried out in an orderly manner according to age.
"In short, this is a social systems engineering that involves a lot of factors. But the core of the matter is that vaccines need to be strong and have accepted scientific data, not the personal opinions of experts. Chen Zhengming said.
Zhang Fengfeng, head of the Department of Epidemiology at the UCLA School of Public Health, told the surging news that when California and even the United States began vaccination, in addition to medical and first-level staff, the elderly were the focus.
"In the United States, the first is for people over the age of seventy to be vaccinated, and then for people over the age of 60. Finally, adults under the age of 60 are vaccinated. He said.
Zhang Fengfeng introduced that at present, there are 7 states in the United States that the elderly over 65 years old have received more than 95% of the two doses of vaccination; 90 to 94.9 percent in 19 states; 85 to 89.9 percent in 15 states and 80 to 85.9 percent in 9 states.
"I suggest that in countries where the vaccination rate of the elderly is not high, we should step up the vaccination rate of the elderly on a voluntary basis to protect them from severe deaths." Prepare early for future outbreaks. He said.