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Following is a question by the Dr Hon Joseph Lee and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (February 20):
Question:
Since the launch of the Hong Kong Childhood Immunisation Programme (CIP) by the Department of Health in the 1960s, except for the addition of the hepatitis B vaccine in 1988 and the introduction of the combined diphtheria, tetanus, acellular pertussis and inactivated poliovirus vaccines in February 2007 to replace the original oral poliovirus vaccine and whole-cell pertussis vaccine, no other vaccines have been added, and no major reform on CIP has been carried out. In this connection, will the Government inform this Council:
(a) of the differences between CIP and similar programmes in the West and developed places in the Asian region;
(b) whether the World Health Organisation has laid down a set of international recommendations on childhood immunisation; if it has, whether CIP complies with such recommendations; if it does not, of the reasons for that; and
(c) given that the Department of Health has indicated that apart from the vaccines recommended in CIP, some private doctors may inoculate children with other self-financed vaccines (including pneumococcal vaccine, influenza vaccine, chickenpox vaccine, hepatitis A vaccine, meningococcal vaccine, Japanese encephalitis vaccine and Haemophilus influenzae type B vaccine), whether the Government will consider including some of those vaccines in CIP within the next three years; if it will, of the vaccines to be included and the time for implementation; if not, the reasons for that?
Reply:
Madam President,
The Expanded Programme on Immunisation (EPI) of the World Health Organisation (WHO) is developed to target at six high-risk infectious diseases, namely, tuberculosis, poliomyelitis, diphtheria, pertussis, tetanus and measles. The WHO has also suggested to its member states that they should assess whether vaccines for other infectious diseases should be included in their childhood immunisation programmes having regard to their local epidemiological profiles. In other words, the types and numbers of vaccines included in such programmes will differ amongst different countries and places. There is also no indication that the more the diseases covered the better. My reply to the three parts of the question is set out below:
(a) A comparison of the childhood immunisation programmes of Hong Kong and some developed countries in the West and Asia is shown in Annex I.
Some Western countries such as the United Kingdom, the United States and Canada have included in their childhood immunisation programmes several new vaccines including those against Haemophilus Influenzae Type B infection and pneumococcal diseases in recent years in the light of their epidemiological profiles. For Asian countries which have epidemiological profiles similar to that of Hong Kong such as Japan, Republic of Korea and Singapore, such vaccines are not included in their childhood immunisation programmes.
(b) The EPI of the WHO mainly targets at six diseases, namely, tuberculosis, poliomyelitis, diphtheria, pertussis, tetanus and measles. The objective of the EPI is to encourage WHO member states to adopt the vaccines in the EPI as a basis for developing their childhood immunisation programmes and to provide them with technical support where necessary. However, member states should include other vaccines in their programmes having regard to the local epidemiological profiles and other factors. Besides, the WHO issues position statements on vaccine application and updates for reference by member states. Currently, the Childhood Immunisation Programme of the Department of Health (DH) is in line with the principles of the WHO's EPI and includes three other vaccines, i.e. vaccines against hepatitis B, mumps and rubella.
(c) At present, the DH's Childhood Immunisation Programme provides prevention against nine childhood infectious diseases, namely tuberculosis, poliomyelitus, hepatitis B, diphtheria, pertussus, tetanus, measles, mumps and rubella. Parents may approach the DH for information and brief guides on vaccines not included in the programme.
Among the seven vaccines which are mentioned in the question but not included in the programme, pneumococcal vaccine, hepatitis A vaccine, chickenpox vaccine and Haemophilus influenzae type B vaccine are covered in a Government-commissioned cost-effectiveness study being conducted by a local university. The study is expected to complete in the first quarter of 2008. Having regard to the findings of the study, the recommendations of the Scientific Committee on Vaccine Preventable Diseases (SCVPD) under the DH's Centre for Health Protection (CHP) as well as other relevant factors, the Government will make a decision on the matter.
As regards the influenza vaccine, the Government has already taken account of people in financial difficulties in its Influenza Vaccination Programme. Free vaccinations against influenza are provided to infants aged six to 23 months from Comprehensive Social Security Assistance families.
The incidence of invasive meningococcal infections is relatively low in Hong Kong. About half of the meningococcal infections were caused by Neisseria meningitidis serogroup B, which is not protected against by the available quadrivalent meningococcal vaccine (which protects against serogroups A, C, Y and W-135). Furthermore, the duration of protection of the vaccine is short, and it is relatively ineffective in children aged under two. Therefore, the SCVPD concludes that there are insufficient justifications to include the quadrivalent meningococcal vaccine in our Childhood Immunisation Programme.
Japanese encephalitis occurs mainly in Asia and the Western Pacific Region, but is rare in Hong Kong. Between 1967 and 2007, nil to five cases were recorded annually in Hong Kong. The findings of the studies conducted by the CHP also show that the disease is not prevalent in Hong Kong over the past 40 years. Besides, Japanese encephalitis vaccination can cause adverse reactions to a certain extent. In view of this, the CHP's Scientific Committee on Vector-borne Diseases concludes that the need for vaccination is not indicated except for people who are going to travel to endemic areas for 30 days or more.
Ends/Wednesday, February 20, 2008
Issued at HKT 13:15
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