Top Hong Kong officials and advisors have rejected calls to relax the Covid-19 Vaccine Pass system, after University of Hong Kong (HKU) epidemiologists Ben Cowling and Theo Chan wrote in an op-ed that the vaccine mandate for listed premises should be dropped for the under 60s.

Since February 24, residents aged over 11 have been required show proof of vaccination to enter restaurants and other scheduled premises. The requirement for a third dose of vaccine kicks in on May 31.

University of Hong Kong epidemiologists Ben Cowling and government advisor David Hui. Photo: HKU, GovHK.

Local respiratory medicine expert and government advisor David Hui told HKFP that “people in Hong Kong won’t go for the third dose unless the threat is imminent. There was enough [of a] problem with the first two doses before Omicron hit Hong Kong hard.”

In response, Cowling told HKFP that he supported vaccination, but – after reviewing ethical concerns – he said he believed there was no need to make the third dose compulsory for the vaccine pass.

Transmission-limiting measure

In the opinion piece published by Ming Pao and HKFP, Cowling and Chan said they believed there was insufficient justification to restrict the movement and activity of young adults who may not satisfy the Vaccine Pass requirements.

Cowling told HKFP that vaccination and social distancing are the two major tools used to contain Covid, with the former aimed at preventing severe disease and the latter used to reduce the chances of transmission and infection.

Photo: Lea Mok/HKFP.

However, Cowling said the protection double-jabbed young adults enjoy from serious symptoms does not diminish significantly over time, according to various studies. Therefore, a mandate for a third jab may not be ethically justified: “If we want to have Covid under control in Hong Kong – meaning we want to have less Covid in Hong Kong – actually, it’s the social distancing measures that are critical. Vaccination is not a transmission-limiting measure,” he said.

T-cell response

Earlier on Tuesday, Hui told RTHK radio that he believed the authorities “certainly will not agree” with the suggestions made by the HKU academics: “Many others may not agree either.”

He later told HKFP that Cowling had not considered how Sinovac jab recipients needed three doses to ensure the best protection, citing the Centre for Health Protection’s guidelines. He said that younger high-risk groups required the third jab too.

Hui also questioned the long-term effectiveness of the vaccine in protecting against severe illness, saying that the level of antibodies diminished over time. A recent study from the US suggested that the “T-cell response” – another line of defence to prevent hospitalisation, severe disease and deaths – also decreased nine months after inoculation.

Police cordoning off the entrance of Sai Wan Estate for Covid-19 lockdown and compulsory testing. Photo: Peter Lee/HKFP.

“Even younger people may have a less pronounced reduction in risk of severe disease; they are more likely to be infected with the possible development of ‘long Covid’ if [the] first booster of mRNA vaccine is not given,” said Hui.

Cowling, in turn, cited World Health Organization data saying that two doses would be enough for young Sinovac recipients, adding that it was “still not clear” if the T-cell response is an accurate indicator of immunity against severe disease.

Next phase of Vaccine Pass

Chief Executive Carrie Lam on Tuesday confirmed that the Vaccine Pass requirements would be tighten as planned on May 31, after she was asked about the opinion piece.

Secretary for the Civil Service Patrick Nip, the director of HKU’s Centre for Infection Ho Pak-leung and CUHK public health scholar Kwok Kin-on also expressed their support for the third dose requirement. Ho and Kwok both said that the Vaccine Pass was an important way to boost vaccination rates.

In all, Hong Kong has reported 1.2 million cases and over 9,300 deaths since the onset of the Covid-19 pandemic.

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Lea Mok

Lea Mok is a multimedia reporter at Hong Kong Free Press. She previously contributed to The Initium, StandNews, MingPao and others. She holds a bachelor's degree in Journalism from the Chinese University of Hong Kong.