HONG KONG — Vaccine hesitation here is not only about science, but also related to Hong Kong's history, identity and current politics. The widespread mistrust toward the Hong Kong administration and the central government in Beijing, false information about China's own SinoVac vaccine is constantly circulating online among those from Hong Kong.

There is misleading media coverage about adverse side effects after vaccination, as well as the slowing down of the epidemic have also further weakened the existing low willingness to vaccination, creating a vicious circle.

First Draft, a research agency tracking disinformation, recently released a study on the challenges of vaccine hesitancy in Hong Kong. It concludes by stating that if the government wants to achieve its goal of a 70% vaccination rate by the end of 2021, it must carefully analyze the types of information circulating and understand people's fundamental concerns before it can improve its public health campaigns and vaccination.

A printed sign indicating SinoVac vaccine at the Community Vaccination Centre —Photo: Ivan Abreu/SOPA Images/ZUMA

"Due to its colonial history, Hong Kong sees vaccine options from the east and the west," said Esther Chan, editor of First Draft's Australian office who wrote the report. On Feb 26, Hong Kong started the vaccination campaign for SinoVac, which is developed and produced by China. This follows the introduction of the US-German Pfizer-BioNTech vaccine, starting on March 10.

However, despite the fact that vaccination is free for Hong Kong citizens and there are sufficient supplies, vaccination rates remain low. According to the Hong Kong government, as of June 9, over 2.74 million vaccines were delivered, with about 1.14 million citizens out of the total 7.5 million population receiving both injections, with the vaccinated rate of only 17.4%.

Opinion polls from YouGov, a UK based poll agency, also showed a similar trend: the number of people in Hong Kong who wish to be vaccinated or those who have already been vaccinated, has dropped from 51% on December 13, 2020, to only 37% on May 10, the lowest in the Asia-Pacific region. Other Asian countries such as Indonesia, India, Malaysia and Vietnam all have more than 70% interviewees who wish to be vaccinated, for Taiwan it was 40%.

While the Hong Kong government is pressing ahead with vaccination, First Draft came to the conclusion that Hong Kong's skepticism about vaccines comes not only from safety and efficacy concerns, but also derives from a deeper distrust of the Hong Kong and Chinese governments. Hong Kongers are not convinced that the government in Beijing is acting in the interest of the people, but for pure political considerations instead.

It's a classic "feedback loop," mixing science, emotion and political anxiety.

Before the outbreak of the COVID-19 virus in late 2019 and early 2020, Hong Kong saw months of protests and unrest over a new law to prosecute locals on mainland China. Even though the movement has cooled down since the virus outbreak, the political situation in Hong Kong had undergone dramatic changes within the pandemic: China enacted the new law, the comprehensive National Security Law; the Hong Kong administration launched a massive probe and prosecution of key pro-democracy figures in January, and revised its electoral system in March to emphasize "Hong Kong is ruled by patriots." In the latest move, Hong Kong Chief Executive Carrie Lam said in early May that a law to combat "false information, hatred and lies' is currently under development.

First Draft points out that Hong Kong's vaccination hesitancy is becoming a classic "feedback loop," mixing science, emotion and political anxiety: as people are worried about the safety, efficiency and the government's stance on the pandemic, vaccine reluctance rises, as does an overall mistrust for the government.

The evidence that political mistrust contributes to vaccine hesitancy in Hong Kong is the fact that most of the disinformation and concerns are around SinoVac. The First Draft study notes that most of the misleading statements were about the safety of the Chinese-produced vaccine, rather than Pfizer BioNTech.

One example is that, after Hong Kong Chief Executive Carrie Lam was injected with SinoVac in live streaming, Facebook, Twitter and LIHKG social media platforms immediately circulated with postings and comparison photos in English and Chinese, questioning whether she was actually secretly taking Pfizer or AstraZeneca. Later, a fake YouTube video of "man develops epilepsy after SinoVac vaccination" went viral.

Chief Executive Carrie Lam getting the Second Jab of SinoVac — Photo: Vernon Yuan/NurPhoto/ZUMA

In addition, incomplete or inaccurate headlines or reports in the media about adverse reactions to vaccinations may further discourage people from getting vaccinated. First Draft found that from February to the present, headlines such as "Vaccine Victim — Another Death from SinoVac" and "12th Person Dies from SinoVac" were widely shared on social media platforms.

With the slow progress of vaccination in Hong Kong, the current Pfizer vaccination has been opened up for 12 year olds and above, while SinoVac is accessible for adults. In order to encourage vaccination, the Hong Kong government has exhausted its efforts, including offering new "vaccine bubble" measures at the end of April, allowing vaccinated groups to attend banquets with more than 20 people, re-entering bars, pubs, nightclubs and karaoke; the Hong Kong Airport Authority announced on May 26 that it will give away 60,000 air tickets in a lucky draw to Hong Kong residents and airport staff who have been vaccinated.

The most sensational of all is the "Get a Free House with Vaccination" lottery announced by Sino Group and Chinese Estates Holdings on May 28th, in which one Hong Kong resident who has completed two injections of vaccination will be selected to receive a 449 square feet (135 square meters) luxury house worth HK$10.8 million ($1.4 million)

In its report, First Draft quotes executive chief Carrie Lam's open criticism that "a small group of people distorts the intention of the community testing program and smears Chinese-made vaccines; (and there were) people stigmatizing and politicizing the vaccine procurement." In this regard, First Draft emphasizes that disinformation is successful because it usually stirs up emotions.

In the case of Hong Kong, it is because people are already concerned about vaccines and the political uncertainty. The report concludes: "Vaccine skepticism does not stay in a bubble, but rather interacts with and plays into existing issues."