Organizing Risks: Frontline Bureaucrats, Vaccine Hesitancy, and the Fragmented Governance in COVID-19 Response

Yan Long, University of California, Berkeley
Wei Luo, Peking University

s novel threats emerge with increasing ambiguity and unpredictability, the authority of science and technology in defining and managing risks has been deeply contested. In the realm of public health, vaccination programs—a cornerstone of state-led risk interventions—have faced growing public resistance, fueled by distrust in government risk management. While existing scholarship has examined how states construct and impose risk frameworks, less is known about how frontline bureaucrats implement, adapt, or resist these frameworks in everyday governance. This article shifts attention to the contradictions and divergences in state risk management by examining how frontline government workers in China engaged with local residents’ vaccine hesitancy during the COVID-19 pandemic. Drawing on 80 in-depth interviews with 50 neighborhood-level government employees in a Southern coastal city, we argue that frontline workers did not simply enforce a coherent state agenda but instead developed disparate strategies in response to bureaucratic pressure and shifting central government guidelines. While some strictly adhered to state directives, others tacitly permitted vaccine hesitancy, selectively accommodating resistance based on residents’ socioeconomic status and neighborhood power dynamics. These findings highlight the multiplicity of risk interventions at the ground level and reveal how frontline bureaucrats actively shape the implementation of state policies, sometimes in ways that contradict official risk narratives. By foregrounding the interactive processes through which risk is organized and negotiated in daily governance, this study contributes to sociological understandings of state power, bureaucracy, and the contested nature of public health interventions in risk societies.

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 Presented in Session 108. The Impact of Health Interventions