China's immunization program vaccine has not increased for ten years. Experts recommend that more type II vaccines be included.

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China's immunization program vaccine has not increased for ten years. Experts recommend that more type II vaccines be included.

2019-04-25 21:30:37 21 ℃


Vaccines in China are divided into two categories: one is the national immunization plan vaccine, which is provided free by the government to citizens, including hepatitis B vaccine, BCG vaccine, etc. The other is other vaccines which need citizens to voluntarily receive vaccines at their own expense. At present, the list of the two types of vaccines issued by various provinces in China is different. The more common vaccines are influenza vaccine, rabies vaccine and varicella vaccine.

In recent years, the Chinese government has repeatedly stated that the second type of vaccine, which is safe and effective, urgently needed by the masses and financially affordable, should be included in the immunization programme so that the masses can enjoy better vaccination services.

In January 2017, the State Council issued the 13th Five-Year Plan on Health and Health, which proposed that "according to the needs of disease prevention, the types of vaccines in the national immunization plan should be adjusted in a timely manner, and safe, effective and financially affordable vaccines should be gradually incorporated into the national immunization plan". In February of that year, the General Office of the State Council issued "Opinions on Further Strengthening the Administration of Vaccine Circulation and Vaccination" and again put forward that the second type of vaccines should be included in the national immunization plan. The National Health and Family Planning Commission should establish an expert advisory committee on the national immunization plan, and jointly with the Ministry of Finance, make recommendations on the inclusion or withdrawal of vaccines from the national immunization plan, which will be submitted to the State Council Publication and implementation.

Wang Junzhi, a researcher of China Food and Drug Verification Research Institute, revealed at the National Vaccine and Health Conference on April 21 that this year, China has decided to incorporate the polio vaccine vaccination "two doses of inactivated polio vaccine (IPV)+two doses of attenuated polio vaccine (OPV)" (referred to as "2+2" program) into the immunization program, which will enhance the prevention of polio antibodies to 89% and 92%. And more than 70%.

Poliomyelitis, also known as "polio", is an acute infectious disease caused by type I, II and III poliovirus infection. It occurs mostly in children under five years of age. Serious cases can lead to paralysis, disability and even death. Vaccination is the most effective and economical measure to prevent and control infectious diseases. He Qinghua, deputy director of the CDC Bureau of the State Health and Health Commission, pointed out at a public event on April 23 that China had successfully eliminated smallpox in 1979 and achieved the goal of polio-free in 2000 because of vaccination. There were no reports of diphtheria cases for 13 consecutive years after 2006. In 2018, fewer than 4,000 measles cases occurred. The incidence of infectious diseases by many vaccines, such as Japanese encephalitis and meningitis, had dropped to the lowest level in history. On average, the rate of hepatitis B virus infection among children under 5 years old has decreased from 9.7% in 1992 to 0.3% in 2014. However, since the former Ministry of Health expanded the number of vaccines from 4 to 14 and preventable infectious diseases from 6 to 15 in 2007, the number of vaccines for immunization planning in China has not been added for more than ten years. For example, Hib vaccines have been included in the immunization programme in 191 of the 194 member countries of the World Health Organization, but China still does not provide free vaccination. Pang Xinghuo, deputy director of the Beijing Center for Disease Control and Prevention and expert of the National Advisory Committee on Immunization Planning, told Interface News that whether a vaccine can be included in the immunization plan needs to take into account the burden of disease, population immunization, the situation of the vaccine itself and financial funding and other factors.

Popular vaccine scientist Taulina also gave suggestions in an interview with the Interface News. The highest priority of vaccination among self-paid vaccines in China should be pneumonia vaccine, combined vaccine and influenza vaccine.

以流感为例,据世界卫生组织统计,每年因流感平均导致61万例死亡,直接医疗费用平均每年约为104亿美元。 According to the data of the former National Health Planning Commission, the vaccination rate of influenza vaccine in China is only 2%. In contrast, adult influenza vaccination coverage in the United States is about 59%.

In fact, the vaccination rate of Class II vaccine in China has been unsatisfactory. Zhang Xuehai, deputy director of Zhejiang CDC, mentioned in his book "Current Situation and Influencing Factors of Type II Vaccine Vaccination in China", that there is still a significant gap between the overall vaccination level of Type II Vaccine and that of Class I Vaccine. Taking Haemophilus influenzae type B vaccine, oral live attenuated rotavirus vaccine, heptavalent pneumococcal conjugate vaccine, live attenuated varicella vaccine and inactivated polio vaccine as examples, the estimated vaccination rate is 4.74-46.72%, while the average reported vaccination rate of the first class vaccine in China is over 90%. The price of

is an important factor to block the full coverage of the second class vaccine. In rural areas or parents with poor health awareness, some vaccines at their own expense cost several hundred yuan per injection, so there is no need to fight. Changjie, Ph. D., Shandong University, has shown that the higher the price parents feel, the lower the likelihood that their children will be vaccinated with the second-class vaccine. In addition, when the State Council revised the Regulations on the Administration of Vaccine Circulation and Vaccination in 2016, the increase in the fees charged by CDC agencies at all levels for Class II vaccines was abolished. Although the amendment of this regulation reduces the burden on the public, the shrinkage of profit margin of vaccination units also has a certain impact on their enthusiasm.

Taulina told Interface News that the health damage caused by diseases and the burden of medical expenses should be taken into account when the second-class vaccines are included in the national immunization program, the safety and effectiveness of vaccines themselves, and whether the market can provide adequate capacity guarantee. More policy analysts pointed out that considering the existing economic burden of the country, the realistic and feasible way is to expand the planning step by step for specific groups at high risk.

Interface News noted that China has been trying to expand the scope of immunization programs in recent years. For example, Shanghai began free vaccination of chickenpox vaccine for school-age children on August 1, 2014, and Shanghai and Beijing also provided free pneumococcal vaccine for the elderly aged 60 and over 65. The List of Biological Products for Vaccination Included in the Payment Range of Medical Insurance Individual Account (Revised in 2018) implemented on April 10, 2018 in Shenzhen has included all the eight second-class vaccines that have entered China since 2011.

Many domestic scholars appeal to the government to give appropriate subsidies to some important vaccines of the second kind in order to increase the willingness of Chinese residents to vaccinate. Some policy experts, who did not want to be named, also said that vaccines have great returns on public health and social benefits, and should not blindly depreciate prices, leading enterprises to participate in government procurement at the expense of quality or not supplying vaccines. "In terms of the value of vaccines, the state should increase investment in the overall consideration."