LCQ9: Helping members of public to receive Coronavirus Disease 2019 vaccines

     Following is a question by the Hon Judy Chan and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (February 23):

Question:

     In response to the severe situation of the Coronavirus Disease 2019 (COVID-19) epidemic and the Government's introduction of the "vaccine pass", the number of people receiving COVID-19 vaccines (the vaccines) has recently increased significantly. Some members of the public have relayed that they wish to receive the BioNTech vaccine, but the future time slots available for booking of quite a number of centres providing this vaccine have been fully taken up. Furthermore, they are concerned about whether their physical conditions are suitable for receiving the vaccines, but quite a number of doctors are reluctant to offer clear advice in this respect, leaving them at a loss. In this connection, will the Government inform this Council:

(1) how it explains to those members of the public choosing to receive the vaccines about the effectiveness of vaccination in providing protection against the Omicron variant;

(2) in Hong Kong, among the people who have received the (i) BioNTech and (ii) Sinovac vaccines, of the respective up-to-date percentages of confirmed, severe and death cases for those contracting the Omicron and the Delta variants;

(3) given that some members of the public have relayed that as some public hospital doctors and private doctors are reluctant to bear the risks, such doctors do not take the initiative to provide vaccine consultation and vaccination services nor issue medical exemption certificates for elderly persons, leaving quite a number of elderly persons at a loss as to whether or not to receive vaccines, whether the Government has issued relevant guidelines to the medical sector; if so, of the details; and

(4) whether it will consider cooperating with private hospitals to provide free online vaccine consultation services for elderly persons, so that elderly persons may expeditiously obtain advice offered by doctors and receive vaccines with peace of mind? 

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 late 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 Judy Chan is as follows:

(1) At the meeting on December 23, 2021, the Joint Scientific Committees (JSC) under the Centre for Health Protection (CHP) of the Department of Health (DH), joined by the Chief Executive's expert advisory panel (EAP), reviewed the latest situation of Omicron variant, studies of effectiveness of COVID-19 vaccines against Omicron variant and overseas recommendations on use of COVID-19 vaccines. The JSC-EAP recommended individuals who are not vaccinated to receive vaccination as soon as possible to protect from severe illnesses and complications. For individuals aged 18 years and above who had received two doses of Comirnaty or CoronaVac vaccine, a third dose of Comirnaty vaccine is strongly recommended while this dose is recommended to be administered as soon as possible six months after the second dose. Nevertheless, personal choice for the vaccines is respected.

     Scientific evidence shows 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. As a matter of urgency, we call upon those not yet vaccinated, especially senior citizens, chronic patients and other immunocompromised persons who face a much higher chance of death after COVID-19 infection, to get vaccinated as early as possible for better self-protection. Members of the public who are eligible for a third dose should also get the dose as soon as possible.

(2) As at 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 hospitalisation, 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.

(3) The DH has issued guidelines (www.covidvaccine.gov.hk/pdf/VSS_DoctorsGuide.pdf) to private doctors participating in the COVID-19 Vaccination Programme and conducted seminars to explain the content of the Vaccination Programme and the arrangements for vaccination and first aid, etc. Furthermore, the DH earlier joined hands with various medical professional bodies to develop and promulgate the "Interim Guidance Notes On Common Medical Diseases and COVID-19 Vaccination in Primary Care Settings" (www.covidvaccine.gov.hk/pdf/Guidance_Notes.pdf) to provide healthcare workers with health guidance on handling different target groups and administration of vaccine, including relevant reference materials provided by the Hong Kong Geriatrics Society. The DH will continue to closely monitor vaccination by members of the public, and review the prevailing guidelines from time to time.

     Under the arrangement of the Vaccine Pass, a person who is medically unsuitable for vaccination may consult a doctor on whether they are unsuitable and obtain from the doctor an 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.

     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.

(4) 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. For elderly persons whose vaccination rate is persistently low, we actively provide multiple channels to encourage and enable them to get vaccinated as early as possible so as to reduce the risk of serious illness and death from infection.

Additional Community Vaccination Centre (CVC) dedicated for elderly to receive CoronaVac vaccine

     To enable more elderly persons 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 those aged 60 or above and persons aged three to 17. 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 elderly who are not familiar with online reservations.

COVID-19 Mobile Vaccination Station (MVS)

     Furthermore, two MVSs shuttling between various housing estates and locations have been set up to provide Comirnaty or 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.

"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 confirmed 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, over 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) 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 (see below table) will continue to provide CoronaVac vaccination service to their members on a walk-in basis. No prior booking is required.
 

Yau Ma Tei EHC	Opens on Thursday only
Tai Po EHC	Opens on Tuesday and Friday only
Tuen Mun Wu Hong EHC	Opens on Monday and Wednesday only

 
District Health Centres (DHC) and DHC Expresses

     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 COVID-19 Vaccination Programme, the HA's General Out-patient Clinics (GOPCs) have all along been providing advice to patients who 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 with regular follow-up appointments at GOPCs who intend to receive COVID-19 vaccination but are in doubt of their suitability. The extra assessment sessions will be provided ahead of the patients' follow-up appointments. 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 talk, 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 enable 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: 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 (relocate 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.