LCQ16: Vaccination for children

     Following is a question by Dr the Hon Pierre Chan and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (April 21):
 
Question:
 
     Under the Hong Kong Childhood Immunisation Programme (HKCIP), children receive various vaccines in the following three stages: (i) newly born (administered by hospitals), (ii) one to 18 months from birth (administered by the Maternal and Child Health Centres (MCHCs) under the Department of Health (DH)), and (iii) Primary One to Primary Six (administered by the School Immunisation Teams under the Centre for Health Protection of DH). Moreover, children aged between six months and below 12 years are eligible for free and subsidised seasonal influenza vaccination (SIV) under the Government Vaccination Programme (GVP) and Vaccination Subsidy Scheme (VSS) respectively. In this connection, will the Government inform this Council:
 
(1) of the following details of HKCIP last year: the respective numbers of doses of vaccines administered to (i) newborn babies by public/private hospitals, (ii) pre-school children by MCHCs, and (iii) primary school students by DH's School Immunisation Teams at schools, with a tabulated breakdown by the infectious disease involved; how such figures compare with the relevant figures of the preceding two years;
 
(2) of the respective vaccination coverage rates among (i) pre-school children and (ii) primary school students last year; how such figures compare with the relevant figures of the preceding two years;
 
(3) of the numbers of doses of vaccines (i) procured for HKCIP, (ii) discarded due to expiry or damage, and (iii) kept in stock, last year by DH and the Hospital Authority respectively; how such figures compare with the relevant figures of the preceding two years;
 
(4) of the amount of expenditure incurred by the Government for procuring vaccines under HKCIP in each of the past three years;
 
(5) of the respective numbers of primary schools and primary school students participating in the outreach SIV activities at schools in each of the past two years; how such figures compare with the relevant figures of the preceding year; the respective numbers of children for whom free SIV was administered under GVP, VSS and the Residential Care Home Vaccination Programme in each of the past three years; and
 
(6) whether it knows the up-to-date number of children who have not turned up for their scheduled appointments to receive various vaccines since the outbreak of the Coronavirus Disease 2019 in Hong Kong early last year; whether DH has taken follow-up actions; if so, of the details; if not, the reasons for that?
 
Reply:
 
President,
 
     The Centre for Health Protection (CHP) of the Department of Health (DH) has been keeping abreast of the latest position of the World Health Organization on immunisation and vaccination, the scientific evidence of new vaccines, the latest global and local epidemiology of vaccine preventable diseases, and the advice and practical experience of health authorities across the world. The Scientific Committee on Vaccine Preventable Diseases under CHP holds regular meetings and gives science-based advice and recommendations to CHP regarding the types of vaccines to be incorporated into the Hong Kong Childhood Immunisation Programme (HKCIP) from the public health perspective in a timely manner. Under the HKCIP, Bacillus Calmette-Guerin (BCG) vaccine and the first dose of hepatitis B (Hep B) vaccine are first given to newborn babies in hospitals. Pre-school children from birth to five years old receive different types of vaccines and boosters at recommended ages of vaccination at DH's Maternal and Child Health Centres (MCHCs). As for primary school children, vaccination is provided at schools by the DH's outreach School Immunisation Teams (SIT). Apart from DH's free vaccination, parents may also arrange their children to receive vaccination in private healthcare facilities or clinics at their own expense. In consultation with DH and the Hospital Authority (HA), consolidated reply to the various parts of the question is as follows:
 
(1) The numbers of doses of various vaccines administered at public and private hospitals, MCHCs and by the SIT in the past three years are at Annexes 1, 2 and 3 respectively.
 
(2) Starting from 2001, DH has conducted territory-wide immunisation coverage surveys on a regular basis to monitor the immunisation coverage rates of pre-school children in Hong Kong (i.e. the percentage of children having received vaccination at recommended ages under the HKCIP) through checking the immunisation records (or vaccination cards) of a sample of children.  According to the survey results, the overall immunisation coverage rates of various vaccines under HKCIP has been maintained at a very high level of over 95 per cent (details at Annex 4).
 
     In addition, primary school students' immunisation records are also checked by the SIT when it provides vaccination at schools every year. The figures show that the overall immunisation coverage rates of Primary one, Primary five and Primary six students have maintained at a high coverage rate (details at Annex 5).
 
(3) and (4) Before ordering vaccines for the HKCIP, the Government will estimate the required quantity on the basis of the number of births for the year and the coverage rates in the past. The Government will then procure the estimated quantity of vaccines through tender in accordance with the established requirements and procedures. A flexibility clause will normally be included in the conditions of the tender to ensure that after the signing of the contract, the quantities ordered can be appropriately adjusted or the contract period can be extended if necessary, so as to minimise the number of vaccines to be discarded or expired vaccines. Vaccine suppliers are required to supply sufficient quantities of vaccines for the HKCIP according to the terms of contract.
 
     At present, the Government procures for the HKCIP on a contract basis the following nine single or combined vaccines for children, namely (1) BCG vaccine; (2) Hep B vaccine; (3) varicella vaccine; (4) diphtheria, tetanus, acellular pertussis and inactivated poliovirus (DTaP-IPV) vaccine; (5) diphtheria, tetanus, acellular pertussis (reduced dose) and inactivated poliovirus (dTap-IPV) vaccine; (6) 13-valent pneumococcal conjugate (PCV13) vaccine; (7) measles, mumps and rubella (MMR) vaccine; (8) measles, mumps, rubella and varicella (MMRV) vaccine and (9) human papillomavirus (HPV) vaccine. As the HKCIP is an ongoing programme, contracts are signed for different vaccines and the contract periods vary accordingly. Suppliers are normally required under the contracts concerned to provide vaccines for a period of two to three years and the cost for procurement of the vaccines depends on the relevant contract price for the vaccines. Details of the contracts signed with vaccine suppliers that are still valid are at Annex 6.
 
(5) The number of primary schools joining seasonal influenza vaccination school outreach activities and the number of children aged between six months and under 12 who received free or subsidised seasonal influenza vaccination in the past three years are at Annexes 7 and 8.
 
(6) DH has all along closely monitored the immunisation coverage of children. We noticed that since the outbreak of COVID-19 in Hong Kong, some parents have not brought their children to the MCHCs for vaccination according to the recommended schedule. Meanwhile, the suspension of face-to-face class has also affected the vaccination for primary students. MCHC staff and the SIT would respectively contact parents of pre-school children who have not yet received the age-appropriate vaccines and that of Secondary one students who have yet to complete their vaccinations under HKCIP by phone, letter and SMS, to remind them to arrange vaccination as soon as possible. The latter may bring their children to SIT offices or family doctors' clinics for vaccination according to their needs. Since mid-May 2020, upon the resumption of face-to-face class in phases in light of the development of local COVID-19 situation, SIT has liaised with schools and arranged students to receive vaccination at schools or SIT offices with strengthened infection control. DH will continue to follow up these students who have not completed the HKCIP and work closely with schools to arrange vaccination for students as early as possible.
 
     We noted that some of the children have already received vaccination in the private healthcare sector, whilst some children living outside Hong Kong have continued vaccination in their place of residence. DH has also conducted a press briefing and issued a press release to encourage parents to maintain up-to-date immunisation for their children for comprehensive and timely protection against infectious diseases, and not to delay vaccination due to the COVID-19 outbreak. Parents with children who are currently not residing in Hong Kong are advised to continue immunisation in their place of residence.