How much did China pay to vaccinate its population against Covid-19? The bill is in

A national health body says the cost per dose was about the same for the main jabs used around the country
But the much bigger burden of enforcing the zero-Covid strategy was shouldered by local governments

Coronavirus China

Zhao Ziwen

Published: 6:00pm, 10 Mar 2023

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China paid roughly US$2 a dose for its main Covid-19 vaccines and spent 150 billion yuan (US$21.5 billion) inoculating its population, according to cost details released for the first time.

In a statement on Thursday, the National Healthcare Security Administration (NHSA), which oversees the state health insurance fund, said the inactivated vaccines – the ones most widely used in China – cost 16 yuan per dose on average.

Most of the shots were made by state-owned Sinopharm and private pharma firm Sinovac.

Two other Chinese vaccines – an adenovirus-vectored jab by CanSino and a protein-based one, mostly by Anhui Zhifei Longcom – also cost about 16 yuan a dose.

That compares with a weighted average purchase price of US$20.69 per dose paid by the US government for 1.2 billion doses of Pfizer and Moderna Covid vaccines, according to the San Francisco-based Henry J. Kaiser Family Foundation.

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The NHSA said it spent 150 billion yuan in 2021 and 2022 buying the vaccines and inoculating the population.

In addition, the state health insurance fund spent 4.3 billion yuan on nucleic acid tests, according to the statement.

But that cost was only a fraction of the outlay on such tests, with the burden for mass testing being borne by local governments since May last year.

Mass testing was a central component of China’s zero-Covid policy, a strategy that was in place for nearly three years and took a major financial toll on local finances.

Hundreds of cities in the country, including metropolises such as Shanghai, Beijing, Guangzhou and Shenzhen, went through countless rounds of mass testing for millions of people, especially after the Omicron coronavirus variant started making inroads last year.

Various cities went into lockdown for weeks and even months at a time to stop the spread of the virus, and set up makeshift hospitals, or fangcang, to isolate Covid cases and their close contacts.

Guangdong, China’s richest and biggest province, spent 71.13 billion yuan in 2022 to battle Covid-19, a bill that amounted to more than 5 per cent of the province’s total financial expenditure.

From 2020 to 2022, it spent 146.79 billion yuan on Covid-19 in total, with costs rising by more than half each year.

The cost of Beijing’s Covid battle also soared to 30 billion yuan last year, or nearly 4.2 per cent of the capital’s financial expenditure.

Economic powerhouse Zhejiang spent 43.50 billion yuan last year and Shanghai 16.77 billion yuan.

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At the same, local government revenue fell by 2.1 per cent in 2022, according to the Ministry of Finance.

Among the 10 fiscal expenditure categories, health expenditure grew the fastest, up 17.8 per cent over the previous year.

“In terms of expenditure, local governments have spent too much on PCR tests, and the actual cost should be much higher,” said Alfred Wu, an associate professor with the Lee Kuan Yew School of Public Policy at the National University of Singapore.

Wu added that sluggish local finances could not be blamed solely on pandemic-related spending, such as testing.

He said the overlong zero-Covid policy also caused social problems, such as protests and distress in the general population that increased the cost of governing.