Table 2.

Seven building blocks of COVID-19 vaccination system strengthening in China

Building blocks	Practices for strengthening vaccination system
Leadership and governance: how to guarantee efficient leadership and clearly positioned responsibility?
Leading body	Establish a leading group to oversee the implementation of mass vaccination, including workforce, mobilization and communication, service delivery and vaccine supply
Cross-departmental accountability	Government community committees and ministries responsible for vaccination mobilization and communication; CDCs for vaccine supply, staff training and technical guidance; community health centres and hospitals responsible for vaccination, and daily update of vaccination demand data from governments and report vaccinated amounts to CDCs
Vaccination strategy	Two-step vaccination strategy with the priority order of key groups maintaining social functions first, followed by the public
Health workforce: how to address the shortage of vaccination workforce?
Workforce allocation	Health workers are allocated to participate in vaccination services after training and qualification exam; each vaccination site is equipped with government personnel, security and volunteers
Training	CDCs are responsible for COVID-19 vaccination training and capacity assessment for medical workers
Responsibility	Doctors for pre-check, registration and medical emergency at vaccination sites, and nurses for injection and vaccine management
Incentive	Economic and noneconomic incentives for medical workers to engage in the additional vaccination work
Vaccination service delivery: how to improve the availability of COVID-19 vaccination services?
Vaccination sites	Traditional vaccination sites, new vaccination sites in hospitals and temporary vaccination sites as needed
Flexible services	Vaccination in health centres or hospitals for residents, door-to-door vaccination for enterprise institutions and schools, and vaccination at airport and railway stations for migrant population
Appointment	Online appointment through various platforms, appointment through community or the employer, and on-site appointment
Treatment of side-effects	Doctors from hospitals shoulder the medical emergency and treatment of side-effects following vaccination
Vaccination mobilization and communication: how to address COVID-19 vaccine hesitancy?
Propaganda and mobilization	Rapid, large-scale and accessible publicity of COVID-19 vaccination on the internet and TV; publicity within institutions and industries by the corresponding government departments; notification by phone call and message, flyers and brochures; household screening by grassroots government staff to find the unvaccinated
Incentive	Incentives for the vaccinated such as living necessities for free or cash
Fight misinformation	Health departments identified and promptly refuted vaccine misinformation through the official websites, traditional media and social media platforms
Vaccine financing: how to raise adequate funds for the COVID-19 vaccines and vaccination?
Free of charge	COVID-19 vaccination is free for the public; 70% of fees for COVID-19 vaccines and vaccination was directly covered by social health insurance, while the remaining was funded through reallocated general taxation
Incentive for workers	Vaccination service fees paid to workers as incentives
Access to vaccines: how to ensure adequate supply and distribution of COVID-19 vaccines?
Procurement and distribution	Provincial CDCs responsible for unified procurement and coordinated distribution of COVID-19 vaccines
Management and inventory	Digital tracking of vaccines by scanning code for each in and out of storehouse. Daily report of the vaccinated number and inventory for each vaccination site
Supply of consumables	Vaccination sites responsible for purchasing syringes and other vaccination consumables which are paid by medical insurance funds
Information system: how to track COVID-19 vaccine circulation and side-effects?
Vaccination tracking	Establish vaccine circulation and vaccination management information system. Each vaccine dose is tracked from production to vaccination by digital tracking code, and individual vaccination records are recorded and stored in this system
Side-effect record	Information system for recording and reporting side-effects following immunization