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China’s Lackluster Vaccination Drive: A Tale of Local Cadre Incentives

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China’s Lackluster Vaccination Drive: A Tale of Local Cadre Incentives

Why was China’s vaccination campaign so little, so late? The key lies in understanding cadres’ daily working routine under Xi Jinping.

China’s Lackluster Vaccination Drive: A Tale of Local Cadre Incentives
Credit: Depositphotos

By December 5, two days before the December 7 release of the “10-point plan” that ended China’s zero COVID policy, 76.6 percent of seniors over 80 years old had received at least one dose of vaccine, and 65.8 percent had received two shots. Only 40 percent of seniors over 80 had received the booster shot. In comparison, 95 percent of seniors over 75 years old in the United States had received at least one shot, and 91 percent had received two shots. In addition, 76.1 percent of seniors over 75 years old had received one booster shot, 61.2 percent had received the second booster (designed for the older population, people who are immunocompromised, and adults who got the Janssen vaccine), and 42 percent had gotten the bivalent booster.

The data is very counterintuitive. If China had the institutional capacity to enforce the zero-COVID policy for three years, why couldn’t it monitor and enforce vaccinations? How could the United States, a country China accused of “lying flat” and lacking state capacity during the COVID-19 outbreak, have a higher vaccination rate among seniors than China?

Some China watchers, both inside and outside of China, jumped to the conclusion that the Chinese government did not push for a national vaccination plan. However, reality points in a different direction. According to several interviewees, local cadres and social workers received a list of unvaccinated people and their personal information, and the government workers had to call and persuade these people to get vaccinated.

In addition, local governments could employ both sticks and carrots to encourage vaccination. In some places, local governments handed out small rewards, such as eggs and coupons, to people who received vaccines. In other localities, local governments used relational punishments (for example, students would not be able to graduate or enter school if their family members were not vaccinated) to force compliance. Local governments also sent vaccination teams to elderly people’s homes to vaccinate them. In the most extreme cases, members of vaccination teams broke into seniors’ homes and jabbed them without their or their families consent.

However, ultimately China failed at the task. Why?

Previous China scholars have mapped out the process of local government policy implementation. Michel Oksenberg and Kenneth Lieberthal pioneered this field by proposing vertical and horizontal (tiao-kuai) systems. The vertical systems of governmental agencies (tiao) intersect with the multitude of horizontal territorial administrations (kuai), which results in conflicts of jurisdiction between tiao and kuai. The Chinese government developed “leadership relationships” and “professional relationships” to sort out this chaos. Under leadership relationships, the superior can send binding orders to lower cadres; under professional relationships, the superior can only request cooperation from lower officials.

Studying the incentives of individual officials, Kevin O’Brien has argued that local cadres in China receive numerous responsibilities and targets under the cadre responsibility system. These targets are policy goals local leaders need to reach. Higher officials evaluate lower cadres’ performances by determining how well they have met their targets. Among these targets, some are “hard targets,” meaning they are binding and involve measurable outcomes. Others are “soft targets” because they are neither binding nor measurable. Local leaders always prefer accomplishing hard targets over soft targets because the former weighs more in assessing their performances. In this case, the vaccination rate is a hard target.

There is another category: veto targets. Higher-level governments adopted veto targets to induce policy implementation. Failing to meet veto targets will overwrite and nullify cadres’ other achievements entirely. They will receive severe punishments, such as losing promotion chances and annual bonuses. Cadres repeatedly failing to meet veto targets will even face demotion and dismissal.

Local governments first adopted a veto target to enforce the one-child policy during the 1980s. In 1991, the central government adopted social control as a veto target; local cadres who failed to control crimes and protests would face severe punishments. Environmental protection became a veto target under Xi, demonstrating Beijing’s resolve to enforce environmental regulations.

The key to understanding China’s vaccination drive lies in understanding cadres’ daily working routine under Xi Jinping. Local cadres face different and often conflicted tasks, signified by multiplying veto targets.

In recent years, veto targets proliferated as local governments pressured cadres to complete different tasks. Yuen Yuen Ang documented that local governments adopted investment attraction as a veto target to promote business. In many places, inflation, tax collection, construction, and many other metrics also became veto targets. One local cadre attested that he faced 17 veto targets.

In addition, cadres were forced to sign separate “responsibility orders,” which declared they would be punished if they could not complete the specific tasks in the orders. Many cadres viewed these responsibility orders as extensions of veto targets, and one cadre admitted that he signed over 20 responsibility orders in one year.

To execute these veto targets, local governments use task lines to ensure policy enforcement. A task line (业务线) is a vertical line of agencies that involves completing a particular task. Unlike a tiao, which only involves one agency, a task line often involves different bureaucracies from the same policy system. It is tentative and usually centers around a single policy goal rather than institutions like the tiao-kuai system. As a result, cadres must work on multiple task lines simultaneously.

Task lines typically originate in higher jurisdictions and transfer orders through the vertical system. For example, one interviewee from a subdistrict Development and Reform Commission (DRC) in Shanghai said she reports to the Shanghai municipal DRC for her task lines. However, she also noted that sometimes she must answer to superiors from other agencies if these orders are within her task lines. As a result, one cadre explained, “unlike a Ph.D. student who only has one adviser, each cadre needs to answer to different superiors in a task line.”

For local administrations, task lines have two utilities. First, task lines strengthen policy implementation by reinforcing vertical leadership. Most Chinese government offices belong to horizontal leadership and answer to local leaders rather than superiors within the same agency. With the introduction of task lines, an official describes herself as following both horizontal and vertical leadership. Task lines strengthen superior agencies by allowing them to issue binding orders. As a result, task lines reduce the room for bargaining between upper and lower officials during policy implementation, because superiors within the vertical system can enforce implementation through task lines.

Second, task lines break through inter-bureaucracy barriers since officials must answer requests from other agencies within the same task line. Therefore, they cut through the traditional leadership and professional relationships and strengthen cooperation among different agencies.

Facing such chaos, how do cadres know what work to do? Seasoned officials can navigate different tasks and prioritize work based on years of experience. They tend to organize work based on deadlines. However, several interviewees claimed they set their priorities based on leadership attention. One cadre said that she decides her work every morning based on “what the leader yelled at me first.”

The introduction of task lines has several consequences. Task lines centralize power to superiors in the township/city/province from the base-level officials in counties and villages. Thus, it creates a dilemma very similar to the soft-centralization approach. In addition, local governments have the freedom to enforce or ignore a national policy by manipulating the task line. If a national policy contradicts provincial priorities, provinces will use task lines to enforce provincial priorities and ignore the national policy.

For example, the State Council issued a work plan to boost seniors’ vaccination rate on December 5. However, among the three local cadres from three different provinces I interviewed, only one had to implement this policy (she was shocked when I told her other places did not have to). The other two cadres said they did not have a task line for this policy. One government worker said, “No one cares about vaccination now because we have a much more urgent task in hand.”

The proliferation of veto targets might also incentivize local governments to fake data to fulfill the target. In Shanxi province, four vaccinations were recorded between 2021 and 2022 for a person who had died in 2019. According to a report from the Qianjiang Evening News, an official newspaper of the Zhejiang Provincial Government, the event is “not an isolated case… many people experienced it or knew someone with this experience.” The report further claims that the local government engaged in such illegal activity to fulfill targets and win awards for vaccination.

Localities might adopt this approach since data falsification culture plagues the government at all levels. For example, one cadre claimed that this activity is unlikely in her jurisdiction – but she also attested that her locality indeed used fake data to fulfill other unattainable targets, such as investment attraction targets, illustrating how prevalent data falsification is in the Chinese bureaucracy.

The unreasonable expectations from superiors to multi-task and the Communist Party’s constant demands for “self-sacrifice” drive cadres to mental and physical collapse. One cadre described her working life as “exhaustive” and “constantly under high pressure,” which greatly impacted her physical and mental health. In addition, she called herself the “party’s cheap labor” since she constantly needed to work overtime without receiving any overtime payment.

During the interview, she even confessed that she is considering quitting her government job and pursuing a Ph.D. degree in social science in the United States. She eventually gave up this idea after hearing endless horror stories of Ph.D. life, such as the never-enough stipend and the dearth of tenure-track professor opportunities after graduation.

This cadre is certainly not a special case, and the implication is significant: China’s vaccine campaign fell short because an exhausted and low-morale cadre force could not keep up with Xi’s grand vision. This is not a problem the party center can fix easily through party-building campaigns.