LCQ4: Immunisation for children

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     Following is a question by the Hon Holden Chow and a reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (June 6):
 
Question:
 
     At present, the Department of Health (DH) provides vaccines and boosters for children from birth to Primary Six under the Hong Kong Childhood Immunisation Programme (the Immunisation Programme) in order to protect them from 11 infectious diseases, such as measles, poliomyelitis and chickenpox. Parents may bring their children from birth to five years of age to the various Maternal and Child Health Centre for immunisation. Inoculators of DH will visit primary schools to provide immunisation service to primary students. Moreover, children aged six months to under 12 years are eligible for free and subsidised seasonal influenza vaccination (SIV) via the Government Vaccination Programme (GVP) and Vaccination Subsidy Scheme (VSS) respectively.  In this connection, will the Government inform this Council:
 
(1) of the number and percentage of children in the relevant age groups receiving the various types of vaccines and boosters under the Immunisation Programme, as well as the number of inoculators visiting schools to provide immunisation service, in each of the past three years;
 
(2) of the number of primary schools participating in the outreach SIV activities at schools organised under VSS in each of the past two years, and the number of primary school students thereby receiving vaccination; the total number of children receiving free SIV via GVP in each of the past three years; and
 
(3) whether it will consider including SIV in the Immunisation Programme in the near future, and deploying inoculators to schools to provide SIV for primary students; if so, of the details, including the additional number of inoculators needed to be recruited; if not, the reasons for that?
 
Reply:
 
President,
 
     Vaccination is an effective means to protect oneself against infectious diseases.  The Government is currently conducting several free vaccination programmes or subsidy schemes (note 1) to provide free or subsidised vaccination services for children of different target groups.
       
     Having consulted the Department of Health (DH), I now give a reply to the three parts of the question by the Hon Holden Chow as follows:
 
(1) Eligible children will receive different types of free vaccines and boosters under the Hong Kong Childhood Immunisation Programme (HKCIP) for the prevention of 11 types of infectious diseases.  Vaccines are first given to newborn babies in hospitals. During their pre-school period, children will receive different types of vaccines and boosters at recommended ages of vaccination at the DH’s Maternal and Child Health Centres (MCHCs). As for primary school children, vaccination is provided at schools by the DH’s outreaching School Immunisation Team (SIT) (details at Annex 1). Apart from the free vaccination provided by the DH, parents may arrange their children to receive vaccination in private healthcare facilities or clinics at their own expense.
 
     In each of the past three years, about 112 000 to 120 000 doses of vaccine were given to newborn babies by public and private hospitals; about 600 000 doses to children by the DH’s MCHCs; and about 160 000 doses to all Primary One and Six school children by the SIT under the HKCIP (details at Annexes 2, 3 and 4 respectively). The number of staff of the SIT was 58 in the financial years from 2015/16 to 2017/18 (details at Annex 5).
      
     Since 2001, the DH has conducted territory-wide immunisation coverage surveys regularly to monitor the vaccination coverage of pre-school children (note 2). The most recent survey conducted in 2015 (note 3) indicated that the overall coverage of various vaccines under the HKCIP had reached as high as above 95% (details at Annex 6). In addition, the SIT examines the immunisation records of primary students when vaccination is provided at schools annually. Statistics show that the vaccination coverage of Primary One and Six students has been consistently maintained above 97% (details at Annex 7).
 
(2) Regarding seasonal influenza vaccination, children aged 6 months to less than 12 years can receive subsidised vaccination at the clinics of private doctors enrolled in the Vaccination Subsidy Scheme (VSS) (note 4). These private doctors can also organise outreach vaccination activities in primary schools. In the seasons of 2016/17 and 2017/18 (note 5), about 17 000 students in 54 primary schools and 24 000 students in 65 primary schools received influenza vaccination respectively under the VSS. While these school outreach vaccination services were provided by private doctors enrolled in the VSS, the logistics and inspection of services were carried out by the Centre for Health Protection (CHP) of the DH.
 
     In addition, children from families receiving Comprehensive Social Security Assistance or those holding valid Certificate for Waiver of Medical Charges may receive free influenza vaccination under the Government Vaccination Programme (GVP) at the DH’s MCHCs (for children aged 6 months to under 6 years) or the Student Health Service Centres (for children aged 6 years to under 12 years) (note 6). In the seasons of 2015/16, 2016/17 and 2017/18 (note 7), some 2 400, 1 600 and 1 900 eligible children received influenza vaccination respectively under the GVP.
 
(3) The CHP has kept abreast of the latest position of the World Health Organization on immunisation and vaccination, the scientific development and application of new vaccines as well as their cost-effectiveness, the latest global and local epidemiology of vaccine preventable diseases, and the experience of other health authorities. The Scientific Committee on Vaccine Preventable Diseases under the CHP holds regular meetings and makes recommendations to the CHP regarding the types of vaccines to be incorporated into the HKCIP from the public health perspective. Generally speaking, the incorporation of a new vaccine to the HKCIP will be based on scientific evidence, taking into account a number of public health considerations including the overall disease burden on society, the efficacy and safety of the vaccine, the availability of other effective preventive measures, cost-effectiveness and public acceptance of the vaccine.
 
     The CHP is actively preparing for the launch of the School Outreach Vaccination Pilot Programme (Pilot Programme) in the 2018/19 school year. Under the Pilot Programme, the Government will provide free outreach influenza vaccination services for participating primary schools by either the Government Outreach Team or the Public-Private-Partnership Outreach Team.  Meanwhile, the CHP is working to enhance the school outreach vaccination services (note 8) under the existing VSS (enhanced outreach VSS) by such ways as increasing the amount of subsidy and strengthening the support for participating private doctors. A list of doctors participating in the enhanced outreach VSS will be uploaded to the CHP’s website in due course.  No extra fees will be charged by these participating private doctors for the service.
      
     Primary schools which will not participate in the Pilot Programme may take the initiative to invite private doctors on the list to provide free outreach vaccination services at their schools.  The CHP will review various modes of influenza vaccination, including services provided by the Government Outreach Team, the Public-Private-Partnership Outreach Team and the enhanced outreach VSS, with a view to working out a mode of vaccination for the future, including whether the Pilot Programme will be regularised and the manpower required.
 
Note 1: They include the Hong Kong Childhood Immunisation Programme, the Government Vaccination Programme and the Vaccination Subsidy Scheme.
Note 2: It refers to the percentage of children having received vaccination at recommended ages under the HKCIP.
Note 3: Immunisation records (or vaccination cards) of children born between 2009 and 2012 were randomly examined.
Note 4: In the seasons of 2015/16, 2016/17 and 2017/18 (as at May 20, 2018), some 45 200, 110 600 and 150 000 eligible children received influenza vaccination respectively under the VSS.
Note 5: As at May 20, 2018.
Note 6: In 2016/17, the Government extended the scope of the eligible target groups of the GVP and the VSS to cover eligible children aged 6 years to under 12 years.  These enhancement measures have been regularised from the season of 2017/18 onwards.
Note 7: As at May 20, 2018.
Note 8: Primary schools, kindergartens and child care centres will be covered.

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