Discourses of COVID-19 vaccination in China: public response to government domination and the emergence of ‘vaccine citizenship’

ABSTRACT

Using online discourse-centred ethnography and focus group discussions, this paper explores evolving discourses of COVID-19 vaccination in China and corresponding public responded. In addition to the state’s intensive control of COVID-19 outbreaks, China initiated independent research and the development of vaccines from the spring of 2020. In line with the state’s emphasis on success in controlling the outbreaks, government propaganda aimed to shape and disseminate successful images of the vaccines developed. Correspondingly, the public showed a supportive attitude when the first two domestically produced vaccines received Emergency Use Authorisation (EUA) by China’s authorities. In contrast, vaccine hesitancy emerged when the government claimed its initial success in pandemic control and tried to communicate the vaccine’s safety and effectiveness. Importantly, COVID-19 outbreaks have never disappeared in China. As new domestic outbreaks emerged and the administration started to promote vaccination more vigorously, more people were forced to accept vaccination. When the government endowed vaccine discourse with the responsibility of protecting the general population’s health, the implementation of the vaccination programme became even more constraining. This paper examines empirical data on the government’s and individuals’ discursive practices through a focus on subjectivity as part of China’s biopolitical governance of COVID-19 which presents vaccination as an individual ‘technology of the self’. In this complex context of top-down governance, I analyse how the exercise of biopower and a sense of governance emerged and changed during China’s efforts at COVID-19 control.

KEYWORDS:

• Vaccine
• COVID-19
• discourse
• China
• biopower

Introduction

The Chinese government has long demonstrated a robust commitment to the development and promotion of domestically produced vaccines. By April 2020, twenty-one COVID-19 vaccines had been developed by Chinese enterprises and were said by the public sector and state propaganda organisations to have entered clinical trials. However, after the introduction of seven products for mass vaccination, a notable contrast emerged between communicated success in vaccine development and palpable public hesitancy.

From a discursive perspective, the government sought to manipulate pandemic knowledge, utilising COVID-19 vaccination in China as a discourse of securitisation, and positioning it as a rational technique to safeguard the population against the risk of infection. Vaccines were viewed as a ‘security apparatus’ (Foucault, 2007), aimed at managing infection risk and anticipating that the dissemination of vaccine efficacy and safety would bolster public adherence. Nevertheless, public hesitancy emerged and lingered, only abating in spring 2021 when the government instituted strict controls over unvaccinated individuals amidst local outbreaks.

This study explores the initiation and efficacy of China’s COVID-19 vaccination programme, intertwining a discursive approach underpinned by Foucauldian perspectives with analysis of nuances of power and knowledge deployment amidst the vaccination campaign. Specifically, the paper scrutinises the trajectory through which the proclaimed success narrative of China’s vaccine development and implementation paradoxically precipitated vaccine hesitancy among the populace. It also examines fluctuations in public attitudes, oscillating between stringent governmental compliance and notable hesitancy, whilst elucidating how such changes were moulded by the interplay between outbreak progression and government vaccine promotion strategies.

The study sheds light on how vaccination, as a tool and process, aided and abetted the Chinese government’s exercise of biopower, facilitating the establishment and operation of a ‘new order’ in local outbreak management, nuanced by vaccination status. A notion of ‘vaccine citizenship’ is suggested as having emerged from both public reaction and governmental implementation, weaving together individual responsibility and attitudes towards vaccination, thereby sculpting an ideational framework of ‘commendable citizenship’ for adherents to vaccination mandates.

Even as the exercise of biopower connected to the government’s exhaustive campaign of vaccine safety and efficacy, the dissemination and implementation process, embodying the biopolitics of vaccination, ostensibly fortified state control and dominance, navigating a complex terrain between public health and authoritarian governance.

Theoretical and contextual framework

This study enquires into the discourse surrounding China’s domestic response to COVID-19, with a lens on its vaccination promotion strategies, positioning these as offering a distinctive case study that offers a unique approach to influencing and regulating self-governance technologies amidst a global health crisis. Informed by Foucault’s perspectives on biopolitics and governmentality, the study provides a detailed re-examination of governance over population health with a focus on its manifestation and the dispersion of biopower through discursive practices in China’s pandemic management context.

Western scholarship has illustrates how government discourses, firmly anchored in neoliberal logic, frequently link healthy behaviours to responsible citizenship, thereby inscribing a ‘moral-political existence’ during a pandemic (Lemke et al., 2011, p. 48). Together, they shape a particular form of governmentality which, employing emerging COVID-19 knowledge, creates a novel domain of pandemic governance by becoming a nucleus of ‘regulation and intervention’ (Lemke, 2002). Thus, discourse not only aspires to ‘conduct, shape and steer human individuals and groups’ (Foucault, 1991, Rose 1989) but concurrently assures governments’ responsibility for preserving societal health, with a focus on population security.

In this study, the concept of ‘vaccine citizenship’ is used to understand the People’s Republic of China’s management of COVID-19, integrating perspectives from both the government and individuals. This approach examines discourses surrounding COVID-19 governance, drawing on Lemke’s (2002) idea of aligning responsible and moral individual behaviour with economic rationality through ‘technologies of the self’ (Foucault, 1988, p. 18). This framework is related to Rose and Novas’s (2007) theories of biological citizenship and governmentality. China’s COVID-19 vaccination strategy offers us a unique case in which sovereign and biopolitical power converge, controlled by the state, limiting individual autonomy (Foucault, 1988, p. 12) and demonstrating state dominance (Lemke, 2002). While biological citizenship usually involves individual engagement with biomedical knowledge, in China, this process is heavily influenced by state authority. The research suggests that biological citizenship can act as a form of resistance to power when it is exercised independently and informed by biomedical knowledge.

Considering the questions on governmentality, I emphasise how the process of shaping the governance of COVID-19 vaccination in China, via the government’s course of action and truthmaking, established a regime of truth. According to Foucault, regimes of truth entail several crucial elements related to knowledge production and the exercise of power that arise from discursive practices, which the empirical elements of this paper will interrogate more fully.

The types of discourse which it accepts and makes function as true; the mechanisms and instances which enable one to distinguish true and false statements; the means by which each is sanctioned; the techniques and procedures accorded value in the acquisition of truth; the status of those who are charged with saying what counts as true (Foucault, 1994, p. 131).

In China, pandemic-related governmental discourses and the ‘production of truth’ concerning the ‘vital character’ of humans (Rabinow and Rose, 2006) legitimated governance, enabling it to expand power beyond mere health promotion, to effect interventions under the aegis of safeguarding national health. Here, members of the public were required to self-regulate, under an authority emanating from articulated ‘truths’ concerning COVID-19 infection risks and vaccine efficacy. The conduit through which COVID-19 vaccination evolved into a pivotal element of self-technology underscores the manner in which governmentality was situated amidst a contested and conflicted power relationship between authoritarian control and individual responses during the pandemic.

In the context of COVID-19 vaccination and high initial acceptance rates (Wouters et al., 2021), hesitancy in China increased alongside domestic outbreaks and intensified during periods of government promotion (Zhang et al., 2022). Questions arose about the state’s propaganda concerning vaccine development, with some scholars praising the accessibility and affordability of Chinese vaccines while others urged caution regarding safety and clinical trial data (Kim et al., 2021). China’s vaccine hesitancy differs from that in other nations, with concerns centred on the importance, necessity, effectiveness, and safety of vaccines, highlighting the government’s role in building trust through reliable forms of information dissemination (Wu et al., 2021). Big data studies, such as those by Sun et al. and Liu et al. (2022), have analysed Chinese discourse surrounding vaccination, revealing the interaction between official mandates and individual opinions.

This body of research generally suggests that China’s unique discourse and positive vaccine attitudes reflect its cultural traits. However, these studies may not fully capture the evolving dynamics between the government and the public, especially in the context of biopolitical power. A more detailed analysis could reveal how individuals navigate their subjectivity in a seriously controlled environment. This paper argues that vaccination in China reflects a transformation of biopower between the government and public. Importantly, governmental discourse does not engage in dialogue with citizens but uses it to centralise authority in knowledge production and policy implementation. This approach, akin to theoretical work advanced by Rabinow and Rose (2006), suggests a form of governance based on domination and control over the population’s health, reflecting a top-down approach to managing public health during the pandemic. In China, the government’s strict control over information about vaccination and the status of vaccinated people has shaped how individuals understand and accept vaccination-related knowledge and norms. This process has given rise to particular versions of vaccine citizenship in China, with the government’s version of the truth playing a central role in discussion.

In summary, this study aims to critically examine COVID-19 related governance through vaccination in China, focusing on how it strengthened population control and the government’s methods to achieve it. Through a focus on individuals’ perceptions and experiences, I intend to apply Foucauldian concepts of power/knowledge, governance and population to make sense of the events. This paper’s inquiry posed the following questions:

• How did vaccine citizenship materialize and function as a norm for controlling knowledge production and individual perceptions of COVID-19 vaccination in China?

• How did evolving attitudes and responses to COVID-19 vaccination, reflected in discursive practices, expose power relations and conflict in shaping popular subjectivities during the pandemic?

Methodological and ethical concerns

During the COVID-19 outbreaks in China, social media platforms became both a means of reflecting public concerns and a tool to promote prevention and control measures (Li & Liu, 2020). Seen from these two perspectives, such an online environment satisfied the emphasis of ethnographic inquiry on exploring a ‘socially shared behaviour’ (Wolcott, 1999, p. 67). In this study, a discourse-centred online ethnography took place to examine how the Chinese government’s manufacture and manipulation of the ‘truths’ concerning the vaccines developed a biopolitics of vaccination in relation with individual acceptance, rejection or hesitancy.

To begin the study, I began by undertaking keyword searches on major social media platforms to distil and categorize content from both individual and official media posts related to vaccination efforts between Spring 2020 and Summer 2021. I chose posts from People’s Daily, Xinhua News, CCTV, and a series of provincial-level official agencies as representative of governmental discourses. I considered a range of different social media accounts and corresponding ‘attention’ levels amongst different audiences. To capture a broader spectrum of discourse, I also examined communication on social media groups. Discussion between January to October 2021 regarding vaccines and vaccination on five local residents’ social media groups in Xiamen, Xi’an, and Shanghai were analysed. Furthermore, drawing on past online ethnography in China, which has underscored the virtual realm’s impact in shaping lived experiences, and the need to understand participants’ situated understandings and lifeworlds, I conducted 10 interviews with social media users, whose posts directly engaged with government information concerning COVID-19 vaccines and vaccination. I saw this as a way of further understand feelings, perceptions and experiences.

In China, the government’s intensive censorship sets limits on the openness of individuals’ online expression. In particular, individual social media users may hesitate to express their real feelings in publicly accessible Weibo posts or in large-scale WeChat groups. Given this, I tried to track how people’s opinions on China’s vaccine emerged and changed in line with government propaganda and its implementation. I identified two specific groups that might be expected to have particular concerns about vaccination: university students and migrant workers. Universities in China had worked hard to maintain infection-free campuses. The majority of students, who live in shared accommodation, faced an major push to be vaccinated to ensure the campus’ safety. Similarly, migrant workers from rural areas who work and live in industry parks were urged by both the companies they worked for and the government to be vaccinated collectively so as to protect the worker community. In June 2021, I organised two focus groups: the first group involved 12 university students in Xiamen, and the second comprised 15 migrant workers at a factory in East China. I conducted the groups using the group meeting function of WeChat.

Through the different sources of data and insight identified above, I aimed to provide a situational examination of the construction and manipulation of COVID-19 vaccination as a ‘technology of the self’, which mirrored the underlying power relations between the individuals and the government during the evolving phases of COVID-19 vaccination. I followed the analytical framework described by Kendall and Wickham (1999). I focused on the initial construction of vaccine-related discourses as constituted by the Chinese government’s systematically organized statements. I then examined the processes of shaping, manipulating and transforming this official ‘regime of truth’ in relation to vaccination, as well as individual perceptions of vaccination that aligned with vaccine hesitancy. This involved identifying the processes by which the government produced dominant discourses; discerning the boundaries between what was identified as supportive of discursive practices and what was not; exploring the contexts in which the individuals’ perceptions of vaccines and vaccination emerged and engaged with the government’s statements; and finally, attempting to understand how these practices were materialized – through the embodiment of notions of ‘vaccine citizenship’.

The study was approved by the ethics committee in the Department of Sociology at Goldsmiths, University of London. From individuals participating in the study, I gained informed consent and kept their details confidential. Likewise, focus group participants were assured of confidentiality. Both groups were afforded anonymity in the reporting of data.

Vaccine discourses and public reactions

Communicating the ‘achievements’ of vaccine development

In this section, I examine how government discourses presented China’s vaccine products as ‘safe and credible’ when combined with the nationalist emotions of the audiences. I explore how the public’s early reactions to the promotion of vaccines and vaccination came to differ from this ‘successful’ image of vaccine products in China. I then reflect on the Chinese government’s interventions which tried to solve problems of vaccine hesitancy.

Since early spring 2020, official narratives in China communicated progress in state vaccine development projects to the general public. Without any clear evidence of vaccine efficacy, government discourses emphasised how was China was the ‘earliest country to focus on COVID-19 vaccine development’, and how its progress from initial development to clinical trials had been ‘speedy and efficient’ (Bai, 2020). The government’s narratives also prepared the ground for a successful, positive outcome by presenting the vaccine research teams’ members as highly regarded scientists (e.g. Behind the Sinopharm Vaccine, 2020). Outside experts expressed unconditional confidence in them with the COVID-19 vaccine being seen as the public’s ‘guardian of health’, since it offered a definitive solution to the COVID-19 pandemic. Moreover, the public should not be worried about any shortcomings in effectiveness and safety. The choice of expert commentators in government narratives enhanced the authority of such discursive practices. They included Zhong Nanshan, the state’s best known scientific figure during the SARS-Cov-1 and COVID-19 pandemics and Chen Wei, who was the principal leader in China’s single-dose vaccine development.

Such discourses represented the government’s effort to court favour in the eyes of the public. From the government’s perspective, discourses from the scientific community were expected to build confidence in the new vaccines. Moreover, at this stage in the pandemic, the notion of a Chinese vaccine provided additional reassurance of forthcoming achievement that confirmed the safeguarding of public health.

The vaccination programme formally began after the vaccine products had received approval by China’s domestic regulator. Producers also started to export their vaccines to other countries for phase-three clinical trials and widespread implementation. Alongside this, vaccine discourses from the government evolved correspondingly. Since the results of phase-three trials were not widely available until the end of 2020, the government relied on phase-two results and expert opinion about the vaccines’ reliability (e.g. Xu, 2020). Meanwhile, a novel discourse of global responsibility had developed in the propaganda surrounding the export of the Chinese manufactured vaccine (e.g. Luo & Ma, 2021).

Informed by the construction of the vaccine’s positive image, the government became more emboldened in encouraging a positive attitude towards domestically produced vaccines. The online ethnography provided some insight into these issues, with the users of Weibo and online forums widely awarding the leaders of the vaccine development programmes with sublime titles such as ‘state scholar’ (国士, guoshi) in recognition of their efforts. A sense of national pride rapidly developed, as online comments increasingly resonated with the government’s description of such products’ as embodying China’s responsibility and strength. In informal discussions in WeChat groups, many Chinese people still expressed confidence in domestically produced vaccines.

In summary, and at this early stage in the response, China’s official narratives sought to present an image of success for its vaccines, and the public initially accepted this image with a sense of national pride. The government’s discursive practices revealed the goal of promoting vaccination as a rational form of governance in managing the securitised biopolitical agenda associated with COVID-19. At this time, the government advanced the vaccine as the technology of the self in two ways: people should be vaccinated so as to become a healthy part of the population, and people should unconditionally support the success of China’s vaccines.

Vaccine hesitancy: a shared dilemma for the government and the public

Based on the state’s successful production and dissemination of encouraging discourse concerning vaccine safety and efficacy, China’s initial vaccine hesitancy may at first sight appear paradoxical. From the government’s perspective, public unconditional acceptance did not happen on a large scale, even when several products, including Corona Vac and Sinopharm BBIPP-CorV, gained World Health Organization approval and were exported to other countries at the end of 2020. The government stressed how Chinese vaccines ‘demonstrated credible results published in authoritative journals’, and the results of their effectiveness ‘met the requirements of WHO stipulations’ (Xinhua News Agency, 2021). Meanwhile, the government tried to block the communication of any information about vaccines manufactured elsewhere (‘foreign’ vaccines), attempting to construct uniform support for domestic products.

However, the public’s initial reaction was not as enthusiastic as expected. I monitored hot topic discussion of vaccine programmes on Weibo, and my online observations were consolidated by comments made in focus group discussions. The data from these two channels showed that most people did not see getting vaccinated as a necessary step, although their positive impression of domestically produced vaccines had not changed. There were several reasons for this.

First, some people viewed the state’s claims of success in controlling COVID-19 outbreaks as a reason for delaying their vaccination. Weibo users publicly stated they would wait for a while before deciding whether or not to get the vaccine, arguing that ‘the outbreak is not there, [so] why shall we take this unnecessary protection?’ They saw social distancing rules and the requirement of wearing masks and washing hands as ‘enough’ measures to protect themselves from COVID-19. As one university student said in the focus group discussion, ‘The vaccine has a certain degree of successful in generating immunity, and it would not increase my benefit in the short term, so why should I get it immediately?’

Second, people were worried about potential adverse outcomes of vaccination and struggled to find reliable information about side effects in the social media. The government sought to counter this through expert interviews, stating that the technology behind the Chinese vaccine was ‘the most developed’ and the products were ‘extremely safe’ (Jiang, 2021). However, individuals’ descriptions of the side effects they experienced aroused public concern and increasing reluctance to undergo vaccination. Under the Weibo hot topic on ‘vaccine’, for example, some individuals described major side effects after being vaccinated. Significantly, some went so far as the regard the vaccine as the potential trigger for a suddenly diagnosed severe disease such as leukaemia.

In the factory workers’ focus group, hesitancy related to side effects became especially apparent. Workers were concerned that being vaccinated could lead to the temporary loss of work, causing unemployment. One of them reported.

I saw some people’s experiences from my hometown social media group saying they had to stop working because of the side effects. I have to make money from my job, I cannot afford to lose the position. The vaccine for me is less important because of this.

Third, while the value of domestic vaccine products was linked tied to national pride, some people expressed the desire on social media to wait for arrival of the imported Pfizer BioNTech COVID-19 vaccine before getting vaccinated. Such opinions incited lively discussion, with some social media users attacked the people who were waiting for the foreign vaccines, calling them ‘traitors’ (叛徒) or ‘xenophiles’ (崇洋媚外). In the focus group discussions, participants stated that they were aware of the development of vaccines elsewhere in the world, and some were more inclined to accept such products. Layla, a university student, said:

To be honest, I am more willing to get this [Pfizer] one. It is based on my experience. When I was a child, my schools always asked us to take various vaccines, and they would provide us with two options: one domestically produced, and one imported vaccine. I observed, most parents would pay the higher price to buy the imported products for their children.

The state’s promotional attitudes and public hesitancy regarding vaccination programme reflected an emerging power struggle at the discursive level. The lack of substantial public participation in vaccination programmes meant that the government’s vaccine discourse lost a lot of its credibility when individuals were later urged to accept the vaccination despite facing the increased risk of infection.

Evolving vaccine discourses during implementation: producing the ‘good citizen’

I turn now to present how the Chinese government tried to handle vaccine hesitancy in two ways: first through the transformation of vaccine discourses; and second through coercion which attempted establish a connection between taking the vaccine and being a ‘responsible citizen’.

Since the Chinese Communist Party (CCP) came into power, slogans and symbols and other images in the print and digital media have been used as effective ways of disseminating propaganda (Lu, 1999). From February 2020 onwards, this technique was widely utilised in relation to COVID-19, with the government employing nationalist narratives to trigger individuals’ sense of responsibility. These narratives included calls to action such as, 头等大事: 接种新冠疫苗 which translates as: ‘The most critical mission in 2021: [is] getting vaccinated!’ Furthermore, popular language has been used as part of vaccine promotion. In spring 2021, Shenzhen’s Municipal Health Committee produced a slogan adapted from the lyrics of a popular song called 学猫叫 (Learning the Meow [the cat’s cry]. The slogan was, 我们一起打疫苗 一起苗苗苗苗苗 or ‘Let’s get vaccinated together, meow-meow-meow-meow-meow together!’ (Shenzhen Health Committee, 2022). In the Mandarin pinyin system, the two characters Miao (苗) and Meow (喵) share the same spelling and pronunciation. Through this use, the Chinese word 疫苗 (yimiao, vaccine) gained a more popular homophonic character. Additionally, the literal meaning of 苗 ‘miao’ in the Chinese language corresponds to positive ideas about beginning and growth. Slogans including such elements initially gained greater acceptance. During the course of this study, I observed that social media users increasingly praised and reposted such slogans as they grew to accept the vaccination agenda. Focus group members expressed similar opinions. As one student said, they regarded the use of such novel means of communication as an improvement in the government’s approach:

At least it (the slogan) demonstrated that the government tried to gain our support in a softer, more attractive way without so much indoctrination.

However, with the passage of time, vaccine discourses gradually changed from persuasion to coercion on the government’s part. When official discourses started describing vaccination as a ‘mission’ that individuals were obliged to undertake, state expectations became being requirements and mandates. Some provincial governments introduced incentives and punitive measures to encourage vaccination. These included rewarding individuals who were vaccinated and restricting unvaccinated people’s access to public spaces (National Health Commission of the PRC, 2021). Meanwhile, government discourses sought to stigmatise the unvaccinated public by asking others to ‘take precautions against them’. Such discourses sought to distinguish the unvaccinated public from ‘normal others’ by either devaluing their unvaccinated status or praising acceptance of vaccination.

While communicative discourses and robust measures attempted to mobilise the public, the sharpest increase in uptake of China’s vaccination programme took place during the re-emergence of domestic outbreaks. From March 2021, official sources starting publishing details of increasing numbers of vaccinations more frequently (Chen & Xu, 2021). The government further sought to consolidate vaccinated and unvaccinated identities through the use of the digital health-code (健康码, jiankang ma) system. Several provinces introduced golden and silver codes which corresponded to full or half vaccination. These two colours sought to be more rewarding to the individuals awarded them than the original green codes, which implied the individual was of low infectious risk.

In response to increasing restrictions from March 2021 onwards, individuals in epidemic areas found themselves without access to public spaces and travel. On social media, questions began to be raised about ‘how and where do we get the vaccine?’ Correspondingly, participants in the focus groups described how the only way to maintain their ‘freedom and right to move about’ was by accepting the vaccine. They noted that unvaccinated people’s freedom of movement was severely restricted, and local residential areas’ lockdowns were only eased after most people had got vaccinated. Both the university student and factory worker groups described vaccination as providing a legitimate way to travel during this period. One participant in the workers group said, ‘If I still stay away from the vaccine, the factory or government may no longer allow me to enter my workspace, and shortly after that I will get fired. What else can do?’. And as one student explained,

We used to have our student ID for crossing the campus gates (before COVID-19). Now we are required to reveal our vaccination status first in our class’s social media group and then use it as a pass to gain free movement in the campus. We were never clearly told that ‘you must take the vaccination’, and this subsequent outcome is more powerful than the earlier mandatory orders.

Throughout all of the above, the government’s attempts to encourage individual autonomy in vaccination remained but collective acceptance of vaccination was not realised by the top-down dissemination of vaccine-related knowledge alone. From this point onwards, vaccination was no longer merely a technology of the self. Instead, individuals were presented with two mutually opposing ‘choices’: either to take the vaccine and be recognised as a healthy, responsible citizens, or refuse to take it and live under the restrictions that were imposed on unvaccinated people. In this way, individuals were increasingly forced to accept vaccination and de facto vaccine citizenship, constituted a new domain of governmental technology.

Discussion

Changing discourses about vaccination in China highlight a paradoxical process shaping the biopolitics of COVID-19 vaccination. The government initially attempted to manage the epidemic through the ‘regimes of truth’ established by scientific knowledge about the COVID-19 vaccine and vaccination. From this perspective, vaccine-related discourses represented an effort to encourage COVID-19 vaccination as a technology of the self, stressing individual responsibility for adopting government advice and being supportive of the vaccination agenda. Within this process, the vaccine’s scientific credibility was paramount as was the sense of responsibility associated with acceptance.

The concept of ‘vaccine citizenship’ emerged with the introduction of the COVID-19 vaccine, highlighting a divide between individual beliefs and state assurances regarding vaccine safety and effectiveness. Initially, the public largely complied with government vaccination directives. However, this compliance shifted as scepticism grew, marking a distinct rift in the concept of ‘vaccine citizenship’. People started constructing their own narratives about vaccination, increasingly at odds with the state’s more urgent messaging. This conflict epitomised a struggle over who defines the narrative in public health. Vaccine citizenship reflects this divide, whereby the state, confronting waning vaccine confidence, attempted to redefine compliance as a personal duty with respect to infection control. This strategy exposed the government’s aim to align the populace with its singular perspective on the pandemic, using the vaccine as a means of enforcing adherence in the context of heightened security needs during the pandemic.

As the vaccination campaign progressed, the dynamic between individual compliance or dissent and corresponding governmental freedoms or restrictions crystallised, coining a new narrative of the ‘good citizen’ during the pandemic. This dialectic of vaccine citizenship presented a departure from biological citizenship as previously conceptualised. Rather than individuals forging biomedical identities through informed engagement with medical knowledge – as documented by Petryna (2004)—the state sought to homogenise vaccine identities by co-opting biomedical knowledge as a means of societal governance. This offered a stark contrast to earlier instances where health-related groups crafted their own claims and advocacy autonomously (e.g. Rosengarten et al., 2021). The notion of a ‘technology of the self’ is profoundly subverted in this milieu. Where once this implied individuals’ adoption of technologies of the self that permitted personal empowerment in health and autonomy, the state’s tactics now overshadowed these personalised strategies, rendering the individual’s consent secondary to government mandates. This encroachment upon personal agency effaced the division between governance and the governed, advancing a form of disciplinary control that diminished the individual’s capacity for self-governance and erected a governmentality that subverted ‘vaccine citizenship’ into a mandate rather than a choice.

In summary, the concept of vaccine citizenship in China during the COVID-19 pandemic offers a critical lens with which to re-evaluate the government’s logic of ruling during the pandemic. This term encapsulates the dynamics between state-imposed public health measures and individual autonomy. In China, the discursive construction and practical implementation of COVID-19 vaccination has gone well beyond the government’s initial claims of it being a scientifically grounded means of protection for the population’s health. The outcome of individuals’ attitudes to vaccination has transformed from an initial sense of national pride to struggling with an obligatory requirement in order to gain access to a normal social life. Correspondingly, the government’s approach to COVID-19 vaccination has transcended traditional biopolitical boundaries, evolving from a public health initiative into a mechanism for redefining societal norms and individual behaviour during a pandemic.

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