There’s been one consistent silver lining to COVID-19 outbreaks: they trigger a surge in vaccinations that provide protection against severe infections in the future. China’s elderly are an exception.

Take Shanghai. After the financial hub emerged from a bruising two-month lockdown and vaccination clinics reopened, the number of fully immunized people age 60 or above increased just 1 percentage point to 63% in mid-June, despite hundreds of deaths.

By July 4, authorities said they had persuaded 70% to get at least a first dose. But scores of older people remain unmoved, like 62-year-old Rong, a diabetic retiree for whom the government’s position was far less convincing than conversations with friends, many of whom are unvaccinated. Cash rewards offered by his local residential community, a grassroots governing body that helps enforce COVID-19 curbs and urges immunization, didn’t move Rong, who refused to provide his full name for privacy concerns.