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In what may be a world first, authorities in Shanghai have started administering an oral version of the Covid-19 vaccine in a bid to get more booster doses into people. Photo: AP

Coronavirus: could China inhale its way out of zero-Covid restrictions with oral inoculations?

  • Authorities in Shanghai have started administering an oral version of a Covid-19 vaccine in a bid to get more booster doses into people
  • ‘It was like drinking a cup of milk tea,’ said one resident after sucking in the new needle-free vaccine

In what appeared to be a world first, Shanghai on Wednesday started administering an inhalable Covid-19 vaccine.

The vaccine, a mist that is sucked in through the mouth, is being offered for free as a booster dose for previously vaccinated people, according to an announcement on an official city social media account.

Scientists hope that such needle-free vaccines will make vaccination more accessible in countries with fragile health systems because they are easier to administer. They also may persuade people who do not like needles to get inoculated.

China wants more people to get booster shots before it relaxes strict pandemic restrictions that are holding back the economy and are increasingly out of sync with the rest of the world. As of mid-October, about 90 per cent of Chinese were fully vaccinated and 57 per cent had received a booster shot.


How ordinary people in China view the country’s ‘dynamic zero-Covid’ policy

How ordinary people in China view the country’s ‘dynamic zero-Covid’ policy

A online video posted by a state media outlet showed people at a community health centre sticking the short nozzle of a white cup into their mouths. The accompanying text said that after slowly inhaling, a person holds their breath for five seconds, with the entire procedure completed in 20 seconds.

“It was like drinking a cup of milk tea,” one Shanghai resident said in the video. “When I breathed it in, it tasted a bit sweet.”

A vaccine taken in the mouth could also fend off the virus before it reaches the rest of the respiratory system, though that would depend in part on the size of the droplets, one expert said.


‘Caught in a dilemma’: Beijingers frustrated by 3 years of Covid travel curbs in Chinese capital

‘Caught in a dilemma’: Beijingers frustrated by 3 years of Covid travel curbs in Chinese capital

Larger droplets would train defences in parts of the mouth and throat, while smaller ones would travel further into the body, said Dr Vineeta Bal, an immunologist in India.


Chinese regulators approved the vaccine for use as a booster in September. It was developed by Chinese biopharmaceutical company CanSino Biologics as an aerosol version of the company’s one-shot adenovirus vaccine, which uses a relatively harmless cold virus.

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The traditional one-shot vaccine has been approved for use in more than 10 markets including China, Hungary, Pakistan, Malaysia, Argentina and Mexico. The inhaled version has received a go-ahead for clinical trials in Malaysia, a Malaysian media report said last month.

Regulators in India have approved a nasal vaccine – another needle-free option – but it has yet to be rolled out. The vaccine, developed in the United States and licensed to Indian vaccine maker Bharat Biotech, is squirted in the nose.

About a dozen nasal vaccines are being tested globally, according to the World Health Organization.

China has relied on domestically developed vaccines, primarily two inactivated vaccines that have proven effective in preventing death and serious disease. However, they are less effective than the Pfizer and Moderna vaccines at stopping the spread of the disease.


Chinese authorities have not mandated vaccination, but instead of proof of vaccination, entry to an office building or other public places requires a negative Covid-19 test.

Hong Kong bans dry goods stalls at Lunar New Year fair for fourth year in a row

Since China implemented its strict zero-Covid policy, only a small proportion of the population has been infected. As a result, it is unclear how widely Covid-19 would spread if restrictions were lifted.
The Communist Party has so far shown no sign of easing the zero-Covid policy, with instructions to local authorities to move quickly to restrict travel and impose lockdowns when even just a few cases are discovered.

Authorities on Wednesday ordered the lockdown of 900,000 people in Wuhan, the city where the virus was first detected in late 2019, for at least five days. In remote Qinghai province, the urban districts of the city of Xining have been locked down since last Friday.

In Beijing, Universal Studios closed its hotels and attractions “to comply with pandemic prevention and control”. The city of more than 21 million people reported 19 new cases in the latest 24-hour period.