LCQ18: Statistics on vaccination against Coronavirus Disease 2019

     Following is a question by the Hon Tang Ka-piu and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (February 23):
 
Question:
 
     Since the outbreak of the fifth wave of the Coronavirus Disease 2019 (COVID-19) epidemic in Hong Kong in December last year, the number of confirmed patients has been persistently at a high level, and quite a number of such patients have already received COVID-19 vaccines (the vaccines). In this connection, will the Government inform this Council:
 
(1) of the total number of confirmed cases since December last year and, among such cases, the respective numbers of (i) locally acquired cases and (ii) imported cases;
 
(2) among the confirmed cases mentioned in (1), of (a) the number of patients who have received the vaccines, with a breakdown by (i) the name of the vaccine (e.g. Sinovac and BioNTech) and (ii) the number of doses (i.e. one dose, two doses and more than two doses) of the vaccine(s) which they have received, as well as (b) the number of patients who have not received any vaccines;
 
(3) of a breakdown of the conditions (i.e. asymptomatic, mild, severe and critical conditions) of the vaccinated patients mentioned in (2)(a) by the number of doses of vaccine(s) they have received; a breakdown of the number of those patients who have not received any vaccines mentioned in (2)(b) by their conditions;
 
(4) whether it knows the total number of the "COVID-19 Vaccination Medical Exemption Certificates" (Certificates) issued by the public and private healthcare systems in the past 12 months, and the average validity period of such Certificates; whether the authorities will closely follow up the situations of those persons who have been issued with the Certificates, so as to reduce their risks of being infected;
 
(5) given that at present the Government only advises pregnant and lactating women to receive the BioNTech vaccine and has not advised them to receive the Sinovac vaccine, but it is learnt that quite a number of such categories of women have been deterred from receiving the BioNTech vaccine due to worries about its effects on their fetuses/babies, whether the authorities will include such categories of women in those persons who may be issued with the Certificates; and
 
(6) whether it will make special arrangements for those groups who have not received any vaccines (including the elderly and children), such as sending outreach teams to the community to facilitate their getting vaccinated and giving them priority in vaccination booking, so as to further boost the vaccination rate?
 
Reply:
 
President,
 
     The COVID-19 pandemic has had an unprecedented and severe impact on the world. Vaccination is the most effective measure to stop the spread of the virus and prevent severe cases, hospitalisation and death. The COVID-19 Vaccination Programme led by the Government was launched in February last year to provide members of the public with two safe and effective COVID-19 vaccines, namely the Comirnaty and CoronaVac vaccines.
 
     In consultation with the Social Welfare Department, my reply to the various parts of the question raised by the Hon Tang Ka-piu is as follows:
 
(1) and (2) From December 31, 2021 to February 15, 2022, the Centre for Health Protection (CHP) of the Department of Health (DH) recorded a total of 14 039 cases that tested positive for the SARS-CoV-2 virus (COVID-19), comprising 13 380 locally acquired cases and 659 imported cases. Out of the cases, 934 cases had received the third dose vaccine, 7 714 cases had received two vaccine doses (Note 1), 1 100 cases had not completed vaccination (i.e. only received one dose) and 3 571 cases had not received the vaccine. The remaining 720 cases have yet to be classified or the information has yet to be verified.

     Scientific evidence and overseas experience show that while the efficacy of COVID-19 vaccine may be diminished by the Omicron variant especially against infection by COVID-19, vaccination remains highly efficacious in preventing or reducing hospitalisation and the chance of developing severe complications after being infected. We must re-double our efforts as a matter of urgency to boost vaccination in order to further build up protection level in the community against the new variants.
 
(3) As February 20, Hong Kong recorded a total of 60 363 confirmed cases of COVID-19. Over 20 200 cases suspected of or tested positive for the SARS-CoV-2 virus required hospitalisation (including hospitalised, discharged and death cases). Out of them, 3 803 patients are currently being treated in the North Lantau Hospital Hong Kong Infection Control Centre, the Hospital Authority (HA) Infectious Disease Centre, the Community Treatment Facility at AsiaWorld-Expo and public hospitals respectively. A total of 311 patients who tested positive or preliminarily positive for COVID-19 had passed away in public hospitals so far. Statistics on hospitalisation of confirmed cases, severe cases, death cases and information on vaccination are pending compilation by the HA.
 
     Since the arrival of the fifth wave (counting from December 31, 2021), as at February 20, there are 47 732 confirmed cases of COVID-19. A total of 106 patients who passed away at public hospitals had tested positive or preliminarily positive for COVID-19. Out of them, 95 patients were aged above 60. 52 patients had not received vaccination or only received one dose, while 5 patients had received two doses. Information on the remaining patients is pending confirmation. The HA is examining the connection of the relevant death cases with COVID-19.
 
(4) Under the arrangement of the Vaccine Pass launched on February 24, a person who is medically unsuitable for vaccination may consult a doctor on whether they are unsuitable and obtain from the doctor a COVID-19 Vaccination Medical Exemption Certificate (Exemption Certificate) accordingly. The validity period of the Exemption Certificate is pre-set at 90 days, with the longest being 180 days. The actual validity period will be decided by the doctor having regard to clinical conditions. As at February 20, around 14 700 Exemption Certificates in digital format had been issued through the HA's Clinical Management System and the Government's eHealth System.
 
     The DH has issued to private doctors guidelines listing out the medical reasons for being not suitable for vaccination. According to overseas and local experience, most people are suitable to receive the CoronaVac and Comirnaty vaccines currently provided in Hong Kong. In particular, medical reasons for being unsuitable for receiving vaccination include having severe and immediate allergic response to both types of COVID-19 vaccines provided in Hong Kong (e.g. having symptoms of shock, difficulty breathing or lowering in blood pressure, etc.).
 
     When considering to issue an Exemption Certificate, doctors need to make reference to the guidelines issued by the DH and act in accordance with the Code of Professional Conduct. They should make clinical decisions regarding whether the patients meet the critiera on the list for not being suitable for vaccination based on clinical judgement. Furthermore, doctors should issue the Exemption Certificate only after verifying that the persons concerned are not suitable to receive the two vaccines mentioned above.
 
(5) The Comirnaty and CoronaVac vaccines provided in Hong Kong are highly effective in preventing severe cases and deaths from COVID-19. They can provide effective protection to those vaccinated in preventing serious complications and even death after infection. Data indicated that, compared with those not pregnant, pregnant women have a higher chance of developing serious complications after contracting COVID-19. The risk of preterm birth is doubled, and the mortality rate during perinatal period is also increased by about 50 per cent. Studies show that getting the COVID-19 vaccine can reduce the risk of hospitalisation and death in pregnant women, and that the vaccines are as effective in pregnant women as in non-pregnant women. In addition, there are also studies which indicate that the antibodies produced by pregnant women after receiving the COVID-19 vaccine can be passed to the foetus through the umbilical cord. Lactating mothers can also provide protection to the baby through breastfeeding. According to the latest recommendations of the drug manufacturer, pregnant women and lactating mothers can be vaccinated with the Comirnaty and CoronaVac vaccines. Experts have also repeatedly pointed out that vaccination is safe and can provide effective protection for the women concerned, and it is recommended that they get vaccinated as soon as possible.
 
(6) To combat the epidemic, the Government has been strongly appealing to and encouraging the public to get vaccinated, with a view to protecting the community by increasing the vaccination rate in Hong Kong. The current epidemic situation is of grave concern, and death and severe cases involving children and elderly persons have been recorded. Children and elderly persons are our focus of protection. We actively provide multiple channels to encourage and facilitate them to get vaccinated as early as possible so as to reduce the risk of serious illness and death from infection.
 
Arrangements for children to receive vaccination
 
     For arrangements for children to receive COVID-19 vaccines, having regard to the advice of the Advisory Panel on COVID-19 Vaccines (Advisory Panel), the Secretary for Food and Health has earlier approved the eligibility of receiving the CoronaVac vaccine to cover individuals aged 3 and above. We gave priority to vaccinating those aged 12 to 17 with the CoronaVac vaccine earlier, and then gradually expanded the coverage to children aged 5 to 11, and then children aged 3 to 4. Apart from parents making reservations for their children to get vaccinated at Community Vaccination Centres (CVCs) (including the CVC at Hong Kong Central Library designated to provide the CoronaVac vaccine to people aged 3 to 17) or private clinics, the Government also provides special appointments for schools and transport services to arrange for students to get vaccinated at CVCs or Student Health Service Centres, and to provide outreach vaccination service at schools to facilitate children to receive the CoronaVac vaccine.
 
     As for the Comirnaty vaccine, having reviewed the relevant efficacy and safety data published, the Advisory Panel suggested allowing children aged 5 to 11 to receive a fractional dose (i.e. one-third of a dose) of the Comirnaty vaccine for adults for "off-label use". The Scientific Committee on Vaccine Preventable Diseases and the Scientific Committee on Emerging and Zoonotic Diseases also did not object to the relevant arrangement. According to recommendations by experts, an interval of 12 weeks is required for children to receive the first and the second doses of the vaccine. ​In view of the special dilution procedure required for providing children with the Comirnaty vaccine, three Children Community Vaccination Centres (CCVCs) have begun to provide services by phase, namely the CCVCs located at Hong Kong Children's Hospital and at the multi-purpose arena on the first floor of Yuen Chau Kok Sports Centre operated by the HA (came into service on February 16), as well as the CCVC at Gleneagles Hospital operated by the University of Hong Kong (will come into service on February 24).
 
Additional CVC dedicated for elderly and children to receive CoronaVac vaccine
 
     To enable more elderly persons, children and teenagers to receive COVID-19 vaccination as early as possible, the Government has set up a dedicated CVC at Hong Kong Central Library on February 23 to provide CoronaVac vaccination service for persons aged 3 to 17 and those aged 60 or above. Meanwhile, the distribution of same-day tickets at CVCs has been limited to eligible persons aged 60 or above starting from January 11 to reserve the quota as far as possible for the elderly who are not familiar with online reservations.
 
Mobile Vaccination Station
 
     Furthermore, two mobile vaccination stations (MVSs) shuttling between various housing estates and locations have been set up to provide Comirnaty and CoronaVac vaccines. The MVSs enable people in the district, in particular elderly persons, to receive COVID-19 vaccine conveniently. Members of the public can walk-in to receive the first, second or third dose vaccine at the MVSs, or make prior booking through a hotline to reduce waiting time. The MVSs also provide vaccination services at secondary schools for students and staff members of schools.
 
"Assess and Vaccinate" Programme for residential care homes
 
     To encourage unvaccinated residents to receive early vaccination so as to reduce their risk of falling seriously ill and death upon infection, the Government launched a pilot programme called the "Assess and Vaccinate" Programme in 10 residential care homes (RCHs) covering residential care homes for the elderly (RCHEs) and residential care homes for persons with disabilities (RCHDs) on September 29, 2021. The pilot programme was later extended to all RCHEs and RCHDs in Hong Kong on October 25, 2021 (the Programme). Under the Programme, arrangements are made for unvaccinated residents to have health assessments by visiting medical officers (VMOs) arranged by RCHs or health maintenance organisations (HMOs) arranged by the Government. Upon confirmation that a resident is suitable for receiving vaccination, and that his/her family members do not clearly oppose vaccination and confirm that they understand the risks posed to the resident, other residents and staff of the RCH by the resident not being vaccinated, the COVID-19 vaccine would be administered to the resident by VMOs or HMOs under the informed consent of the resident or his/her legal guardian, so as to give early protection to him/her. During the period, VMOs or HMOs also provide health talks/health consultation to residents and their families in need so that they can better understand the vaccine effectiveness to allay their concerns. From the launch of the Programme in late September 2021 to February 20, 2022, about 13 000 RCH residents in Hong Kong have received the first dose of COVID-19 vaccine through outreach services.
 
     In response to the recent worsening epidemic situation, in order to protect residents and staff, the Government has made arrangements with VMOs and HMOs to give priority to providing services to RCHs. In addition, the Government has also mobilised and organised more medical professionals in the field and simplified the process of health assessment and vaccination, so as to conduct health assessment and vaccination for residents as soon as possible.
 
Elderly Health Centres
 
     From January 13 to February 28, 15 Elderly Health Centres (EHCs) (Note 2) under the DH provide CoronaVac vaccination service to all elderly aged 65 or above on a walk-in basis from Monday to Saturday (excluding public holidays). No prior booking is required. The other three EHCs (Note 3) will continue to provide CoronaVac vaccination service to their members on a walk-in basis on the following days. No prior booking is required.
 

 
District Health Centres and District Health Centres Expresses
 
     District Health Centres (DHC) and DHC Expresses under the Food and Health Bureau have been actively promoting and taking part in anti-epidemic work at district level. Apart from promoting and encouraging the public to receive vaccination and providing related education through on-site and on-line means, DHC and DHC Expresses also assist those in need, especially the elderly, in making appointments for vaccination at CVCs, MVSs, private doctors / clinics etc. At the same time, in response to local demand for COVID-19 vaccination, DHCs and DHC Expresses also collaborate with medical practitioners in the community to render outreach vaccination service at DHCs/DHC Expresses.
 
Health consultation and publicity activities
 
     In support of the Government's COVID-19 Vaccination Programme, the HA's General Out-patient Clinics (GOPCs) have all along been providing advice to patients who intend to receive COVID-19 vaccination but are in doubt of their suitability for receiving COVID-19 vaccination. To further enhance the service, since June 25 2021, all 73 GOPCs under the HA have been offering additional assessment sessions to chronic patients who intend to receive COVID-19 vaccination but are in doubt of their suitability and are with regular follow-up appointments at GOPCs. Doctors will assess the clinical conditions of the patients to aid them in making decision on vaccination.
 
     On the other hand, from August 2021 to the end of 2021, District Offices and non-governmental orgainsations organised about 50 vaccination events offering one-stop services covering health talks, health consultation and on-site vaccination. Over 10 000 members of the public and elderly residents participated in these events.
 
     In terms of health promotion, the CHP under the DH disseminates information on vaccination through newspapers, promotional videos, websites and social media platforms, etc. to facilitate the elderly to obtain the latest information. At the same time, the CHP has also prepared leaflets to distribute through different channels, calling on the elderly to get vaccinated as soon as possible in order to protect themselves and their families.
 
     We have noticed that the COVID-19 vaccination rate among the elderly has been increasing since the beginning of January. Over 72 per cent of the elderly aged 70 to 79 has received their first dose of the vaccine, and the vaccination rate for the elderly aged 80 and above has increased to 43 per cent as well.
 
Note 1: For individual cases, depending on the brand of the vaccine received, "completing a vaccination course" may be defined as having received one dose of vaccine or three doses of vaccine.
 
Note 2: Namely Sai Ying Pun EHC, Shau Kei Wan EHC, Aberdeen EHC, Wan Chai EHC, Kowloon City EHC, Lam Tin EHC, Nam Shan EHC, San Po Kong EHC (relocated to Kowloon City Lions Clubs Student Health Service Centre starting from February 16), Tung Chung EHC, Kwai Shing EHC, Shek Wu Hui EHC, Tseung Kwan O EHC, Lek Yuen EHC, Tsuen Wan EHC and Yuen Long EHC.
 
Note 3: Namely Yau Ma Tei EHC, Tai Po EHC and Tuen Mun Wu Hong EHC.