In December, China announced that it planned to inoculate 50 million people against COVID-19 by Feb. 11. Although it was an ambitious goal, it wasn’t outlandish for a country that seemed to have done better than most in bringing the pandemic under control.

Yet vaccination turns out to be the one virus benchmark where China has fared badly: As of Feb. 22, it had managed just 2.89 doses per 100 people (or 40.5 million shots), according to Bloomberg’s vaccine tracker. By contrast, the United States has administered 19.33 doses for every 100 people (a world-beating 64.18 million).

Manufacturing issues and vaccine export diplomacy have certainly played a role in this underperformance. But a far more important factor is longstanding Chinese concerns over vaccine safety and side-effects. Bloomberg News recently reported that the proportion of employees at Chinese firms it contacted who were interested in getting the shot ranged from one-third to less than half. For China to hit its goals, and achieve herd immunity, it will need to encourage more citizens to get over their fears.