China
China’s adult immunization landscape is currently underdeveloped and faces significant challenges, making adult vaccination a relatively low priority compared to childhood immunization programs, which remain the national focus.
Overview
China’s adult immunization landscape is currently underdeveloped and faces significant challenges, making adult vaccination a relatively low priority compared to childhood immunization programs, which remain the national focus. Although China has an extensive and free pediatric immunization program through its Expanded Program on Immunization (EPI), adult immunization still lacks comprehensive national strategies, sufficient funding, and public awareness.
A recent 2022 survey by China CDC showed adult vaccine coverage remains very low for key vaccines: pneumococcal polysaccharide vaccine (PPSV23) coverage was just 0.06% in adults aged 18–59 and 1% in those 60+, influenza vaccine coverage was under 5% for adults 60+, and HPV vaccine uptake among eligible adult females was less than 3% for first dose and under 1% for full course.1,2 Common barriers include lack of public awareness, insufficient healthcare infrastructure for adult vaccination, limited financing mechanisms, and vaccine hesitancy.
Government efforts to promote adult vaccination are still emerging, with calls from experts for multipronged strategies involving standards, financing, education, access improvements, and integrated planning. Seasonal influenza vaccines and pneumococcal vaccines are generally not funded universally for adults at the central government level,
further limiting uptake. Uptake rates vary regionally; for example, influenza vaccination rates in eastern provinces with subsidized programs may reach 40–50% for older adults but remain below 1% in younger adults nationally.3
In contrast to other countries, China has not yet established broad adult immunization targets or a national adult vaccination schedule on par with its pediatric program.4 However, leveraging lessons from recent COVID-19 vaccination campaigns and localized free vaccine programs (e.g., for HPV in certain provinces) has created momentum for expanding adult coverage in future.
Overall, adult immunization in China is recognized as critically important given its aging population and disease burden, but structural, financial, and awareness obstacles must be overcome before it can become a national public health priority comparable to the child-focused immunization program.
Sources:
1. VaxLab Duke Kunshan University. (2024, September). China’s adult vaccination coverage is low and still faces five major challenges.
2. International Federation of Pharmaceutical Manufacturers & Associations. (2022, December 12). Life-course immunization: Country landscape report addendum.
3. National Center for Biotechnology Information. (2025). Vaccine introduction financing in China.
4. Dong, B., Xu, H., Tang, N., Jiang, M., Lei, Z., & Han, Y. (2025, June 5). Analysis of key factors and equity in influenza vaccination among Chinese adults — Evidence from a large national cross-sectional survey. Frontiers in Public Health.
China
China’s adult immunization landscape is currently underdeveloped and faces significant challenges, making adult vaccination a relatively low priority compared to childhood immunization programs, which remain the national focus. Although China has an extensive and free pediatric immunization program through its Expanded Program on Immunization (EPI), adult immunization still lacks comprehensive national strategies, sufficient funding, and public awareness.
Annual Number of Cases
RSV (2023)
Aggregate of monthly case reports.
Annual Number of Cases
COVID-19 (2025)
Aggregate of monthly case reports.
Annual Number of Cases
Shingles
No info.
Not a notifiable disease.
Annual Number of Cases
Influenza (2025)
Aggregate of monthly case reports.
Vaccine Cost
RSV
Adult RSV vaccines (Arexvy and Abrysvo) are not approved in China yet
Sources:
Vaccine Cost
COVID-19 (2025)
No info.
Vaccine Cost
Shingles
Shingrix is not publicly funded and requires out-of-pocket payment
Vaccine Cost
Influenza (2025)
No info.
Vaccine Availability
RSV
No.
Sources:
Vaccine Availability
COVID-19
Available in 2021
Vaccine Availability
Shingles
Available in 2020
Vaccine Availability
Influenza
Available - Seasonal
Sources:
Targeted Age Range
RSV
Adult RSV vaccines (Arexvy and Abrysvo) are not approved in China yet. In February 2026, Arexvy was accepted for regulatory review in China for adults aged 60 and older. Beyfortus (nirsevimab), a preventive RSV antibody, is approved for infants
Sources:
Targeted Age Range
COVID-19
no info.
Targeted Age Range
Shingles
General: Shingrix is approved for people aged 18 and older who are immunocompromised; not in the National Immunization Schedule, as China does not have a comprehensive program for adults (only child-focused)
Older Adult-specific Recommendation: Shingrix is approved for people aged 50 and older; not in the National Immunization Schedule, as China does not have a comprehensive program for adults (only child-focused)
Sources:
Targeted Age Range
Influenza
All people aged 6 months and older. "The following priority and high-risk groups are recommended to get vaccinated in a timely manner: healthcare workers; individuals aged 60 and older; individuals with chronic diseases; vulnerable individuals and staff in nursing homes, long-term care facilities, and welfare institutions; pregnant women; children aged 6-59 months; household members and caregivers of infants aged less than 6 months; individuals in key locations such as daycare centers, primary and secondary schools, and regulatory facilities."
Among those 60+:
625,655 hospitalizations (estimated)
This tab provides data on the annual infection rates for each disease per country based on the most recent year with available data
Annual Number of Cases
Latest year: 2023
| AP-CHAAI Estimate | How was this calculated? | Source | Caveats |
|---|---|---|---|
| 625655 | aggregate of monthly case reports | National Disease Control and Prevention Administration | Limited sentinel data - actual rates expected to be much higher |
This tab provides data on the annual infection rates for each disease per country based on the most recent year with available data
Annual Number of Cases
Latest year: 2025
| AP-CHAAI Estimate | How was this calculated? | Source | Caveats |
|---|---|---|---|
| 1560767 | aggregate of monthly case reports | National Disease Control and Prevention Administration | Limited sentinel data - actual rates expected to be much higher |
This tab provides data on the annual infection rates for each disease per country based on the most recent year with available data
Annual Number of Cases
Latest year: 2025
| AP-CHAAI Estimate | How was this calculated? | Source | Caveats |
|---|---|---|---|
| no info. | Not a notifiable disease. |
This tab provides data on the annual infection rates for each disease per country based on the most recent year with available data
Annual Number of Cases
Latest year: 2025
| AP-CHAAI Estimate | How was this calculated? | Source | Caveats |
|---|---|---|---|
| 17181873 | aggregate of monthly case reports | National Disease Control and Prevention Administration | Limited sentinel data - actual rates expected to be much higher |
This tab provides data on the cost of vaccines for each disease, per country.
Vaccine Cost
Latest year: 2025
| AP-CHAAI Estimate | Source | Calculation | Caveats |
|---|---|---|---|
| Adult RSV vaccines (Arexvy and Abrysvo) are not approved in China yet | GSK Press Release | (GSK - manufacturer of Arexvy) |
This tab provides data on the cost of vaccines for each disease, per country.
Vaccine Cost
Latest year: 2025
| AP-CHAAI Estimate | Source | Calculation | Caveats |
|---|---|---|---|
| no info. |
This tab provides data on the cost of vaccines for each disease, per country.
Vaccine Cost
| AP-CHAAI Estimate | Source | Calculation | Caveats |
|---|---|---|---|
| Shingrix is not publicly funded and requires out-of-pocket payment |
This tab provides data on the cost of vaccines for each disease, per country.
Vaccine Cost
Latest year: 2025
| AP-CHAAI Estimate | Source | Calculation | Caveats |
|---|---|---|---|
| no info. |
This tab provides data on the availability of vaccines for each disease, per country.
Vaccine Availability
| Available and Year? | Source | Caveats |
|---|---|---|
| No | gxj.hefei.gov.cn | Phase II trials started June 2025 |
This tab provides data on the availability of vaccines for each disease, per country.
Vaccine Availability
| Available and Year? | Source | Caveats |
|---|---|---|
| Yes, 2021 | National Medical Products Administration |
This tab provides data on the availability of vaccines for each disease, per country.
Vaccine Availability
| Available and Year? | Source | Caveats |
|---|---|---|
| Yes, 2020 | National Medical Products Administration |
This tab provides data on the availability of vaccines for each disease, per country.
Vaccine Availability
| Available and Year? | Source | Caveats |
|---|---|---|
| Yes, Seasonal | China CDC |
This tab provides data on the targeted age range of adult vaccines for each disease, per country.
Targeted Age Range
| AP-CHAAI Estimate (General) | AP-CHAAI Estimate (Older Adult-specific Recommendation) | Source | How was this calculated? |
|---|---|---|---|
| Adult RSV vaccines (Arexvy and Abrysvo) are not approved in China yet. In February 2026, Arexvy was accepted for regulatory review in China for adults aged 60 and older. Beyfortus (nirsevimab), a preventive RSV antibody, is approved for infants | GSK Press Release | (manufacturer of Arexvy) | |
This tab provides data on the targeted age range of adult vaccines for each disease, per country.
Targeted Age Range
| AP-CHAAI Estimate (General) | AP-CHAAI Estimate (Older Adult-specific Recommendation) | Source | How was this calculated? |
|---|---|---|---|
| no info. | no info. |
This tab provides data on the targeted age range of adult vaccines for each disease, per country.
Targeted Age Range
| AP-CHAAI Estimate (General) | AP-CHAAI Estimate (Older Adult-specific Recommendation) | Source | How was this calculated? |
|---|---|---|---|
| Shingrix is approved for people aged 18 and older who are immunocompromised; not in the National Immunization Schedule, as China does not have a comprehensive program for adults (only child-focused) | Shingrix is approved for people aged 50 and older; not in the National Immunization Schedule, as China does not have a comprehensive program for adults (only child-focused) | GSK Press Release | (manufacturer of Shingrix) |
This tab provides data on the targeted age range of adult vaccines for each disease, per country.
Targeted Age Range
| AP-CHAAI Estimate (General) | AP-CHAAI Estimate (Older Adult-specific Recommendation) | Source | How was this calculated? |
|---|---|---|---|
| All people aged 6 months and older. "The following priority and high-risk groups are recommended to get vaccinated in a timely manner: healthcare workers; individuals aged 60 and older; individuals with chronic diseases; vulnerable individuals and staff in nursing homes, long-term care facilities, and welfare institutions; pregnant women; children aged 6-59 months; household members and caregivers of infants aged less than 6 months; individuals in key locations such as daycare centers, primary and secondary schools, and regulatory facilities." | Chinese Center for Disease Control and Prevention (CDC) | found the information on the official govt. website | |
CHINA
The National Immunization Advisory Committee
The National Immunization Advisory Committee (NIAC) comprises 27 voting members from across China, all recognized experts in fields such as epidemiology, biostatistics, microbiology, vaccinology, clinical medicine (including pediatrics, internal medicine, immunology, and infectious diseases), health policy, economics, and immunization practices. Members serve three-year terms, renewable once.1 NIAC also includes one chair and two vice chairs, each appointed for a three-year term.
The selection process involves four steps: (1) the Secretariat nominates 50% more candidates than the number of available positions; (2) nominees confirm their candidacy and receive institutional approval; (3) the Secretariat submits formal nominations to the National Health Commission (NHC); and (4) the Minister of Health appoints members through official documentation. Current NIAC members represent 19 organizations across seven areas of expertise.2
NIAC's mandate covers all vaccine- and immunization-related issues.3 Agendas are shaped by shifts in the epidemiology of vaccine-preventable diseases, the introduction of new vaccines, and emerging evidence on existing products. The committee provides recommendations on vaccine use, updates to the national immunization schedule, and vaccination strategies for high-risk populations across all age groups.
RSV in Older Adults in China
China's adult RSV immunization landscape is currently emerging, with no RSV vaccines yet approved by national regulators for use in older adults as of mid-2025.4 However, awareness and expert consensus on the disease burden and the need for vaccination among older Chinese adults are growing rapidly.
This first phase of our work focuses on RSV. Additional disease areas will be added as the dataset and analysis continue to expand.
RSV is recognized as a major cause of respiratory illness among adults aged 60 and above in China, especially those with chronic conditions like COPD, heart failure, and diabetes. These populations face elevated risks of severe illness and hospitalization from RSV infections.
An expert consensus released in June 2025 by the Chinese Academy of Medical Sciences and Peking Union Medical College emphasized the urgent need for integrated RSV prevention strategies for older adults, including vaccination once RSV vaccines gain regulatory approval in China. This consensus calls for prioritizing adults ≥75 years before the RSV season, with gradual expansion of age-appropriate immunization strategies. 1
RSV Vaccine Development and Trials
- Recombinant RSV vaccines are under clinical development in China, such as the G protein-based recombinant vaccine BARS13. Phase II trials of BARS13 in adults aged 60 to 80 have shown a good safety profile, tolerability, and strong immune responses, with antibody levels increasing notably at higher antigen doses.5,6
- Continued research is needed to define optimal dosing and long-term protection but preliminary data support advancing these vaccine candidates for older adult use in China.
Policy and Vaccination Uptake
- While no RSV vaccine has received national approval for older adults in China yet, international real-world evidence shows RSV vaccines reduce lower respiratory tract infections and hospitalizations with good safety, demonstrating potential impact for China.7
- Experts recommend strengthening RSV surveillance systems to monitor disease burden and vaccine impact, along with public education and healthcare worker training to enhance awareness and future vaccine uptake.8,9
- Comprehensive rollout strategies could include expanded vaccination services and insurance coverage to encourage uptake.
China’s RSV adult immunization efforts remain in early stages, driven by mounting recognition of RSV's health impact on older adults and promising clinical trial progress. Formal vaccine approvals and targeted introduction policies are anticipated as evidence accumulates and regulatory reviews proceed.