A thread on vaccine hesitancy in Hong Kong, a city fortunate enough to have handled the pandemic relatively skillfully from the outset and also procured enough vaccines for its entire pop of around 7.5m. But it's now struggling for several reasons.

https://www.bloomberg.com/news/articles/2021-05-09/unused-shots-pile-up-as-mistrust-blights-hong-kong-vaccine-drive?srnd=premium-asia&sref=boLeWatK

The city was always going to struggle with vaccine hesitancy. One CUHK survey found only 37% of adults would get the jab; while more recent HKU polling has shown it overs around 50%, lower than other jurisdictions in Asia/globally -- as well as below threshold for herd immunity.

To contrast briefly with Singapore. HK now has 11.6% vaccination rate, compared to 19.4% in Singapore. But in SG, most adults haven't yet been granted access, while HK has gradually allowed vaccines *for anyone over the age of 16* as priority groups failed to show up for shots.

And the evidence for priority groups not getting vaccinated in Hong Kong is shocking, given the global context. Just 3.4% of people over 80 have gotten the jab, despite a much higher risk of serious illness/death. Basically, doctors are advising them not to (more on that later)

There are essentially two main explanations for Hong Kong's perplexing vaccine hesitancy. But there are a number of other considerations that are worth mentioning, particularly given the public policy impact of some of them.

The first is the comparatively low case count (just 11,800) and deaths (210 which is still less than the local death toll from SARS in early 2000s, making it, as far as I am aware, the only place in the world to have more deaths from SARS than Covid.)

The second (and more unique to HK) is the intense atmosphere of mistrust, fear and political polarization that have followed the 2019 pro-democracy protests and the China-led crackdown on political freedoms that followed. This is a factor not applicable to most of developed Asia.

One comment along these lines getting a bit of attention is this one from a young student: "I won’t take the vaccine, because my friends and I just don’t want to follow any instructions or recommendations from the government. I don’t trust anything from them."

But perhaps more concerning is the concluding comment from a nurse who works in a hospital that also handles Covid patients, and doesn't want to get vaccinated b/c he doesn't believe the government's assurances on side effects/deaths. https://www.bloomberg.com/news/articles/2021-05-09/unused-shots-pile-up-as-mistrust-blights-hong-kong-vaccine-drive?srnd=premium-asia&sref=boLeWatK

Yet there are some other explanations as well. One govt adviser (himself a doctor, who used to chair a hospital here) said docs here are incredibly conservative, and are advising patients to mostly skip the jab if they have even the most minor illnesses.

This doctor was surprised most of these people would even bother consulting doctors. Anecdotally, one HK surgeon I dealt with recently (minor procedure) asked me what jab I had got... & when I asked him in return, he admitted he hadn't gotten the shot. Seemed almost embarrassed