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Following is a question by the Hon Frederick Fung and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (June 18):
Question:
Regarding the Childhood Immunisation Programme (CIP), will the Government inform this Council:
(a) whether the study commissioned by the Department of Health (DH) and undertaken by a university on the cost-effectiveness of incorporating pneumococcal vaccine, chickenpox vaccine, hepatitis A vaccine and Haemophilus influenza type B vaccine into CIP has been completed; if so, of the findings; if the Scientific Committee on Vaccine Preventable Diseases under DH has made recommendation whether the aforesaid vaccines should be included in CIP; when the authorities will decide to introduce changes to CIP;
(b) as it has been reported that the Government has decided to abandon its original plan to inoculate all children under 12 years of age with influenza vaccines for free, and will instead provide financial support in the form of $100 each for children aged between six months and five years to receive inoculation against influenza at private clinics, of the details of the new plan, the annual expenditure involved and the rationale for adopting the new plan, as well as how it addresses the problems of the significant differences in and insufficient transparency of the fees charged by private doctors for the inoculations; and
(c) as it has been reported that the Government is considering inoculating all children under two years of age with pneumococcal vaccine for free, of the details of this plan and the annual expenditure involved; whether it has estimated the amount of annual savings, after implementing this inoculation plan, in medical expenditure for treating complications arising from pneumococcal infections?
Reply:
Madam President,
(a) & (c) The Centre for Health Protection (CHP) of the Department of Health (DH) has commissioned a local university to conduct a study to review the cost-effectiveness and cost-benefit of incorporating four child vaccines into the Childhood Immunisation Programme (CIP). The findings of the study have already been submitted by the university concerned to the Secretariat of the Research Fund for the Control of Infectious Diseases (RFCID) for review, while the initial findings have also been discussed earlier at a meeting of the Scientific Committee on Vaccine Preventable Diseases (SCVPD) under CHP of DH. The study will only be finalised after going through the review process by RFCID. After the review and endorsement of the study, the Government will consider its findings and the recommendations of the SCVPD before making a decision on whether it is necessary to incorporate new vaccines, including pneumococcal vaccines, in our CIP.
(b) Each year, the SCVPD recommends the target groups for influenza vaccination in the light of the review of local and overseas scientific evidence regarding influenza vaccination, the World Health Organisation's recommendations and assessment of the latest influenza situation. The SCVPD has already submitted to the Government its recommendations on influenza vaccination for 2008-09, and the recommendations have also been uploaded onto the CHP's website.
This year, in addition to the target groups already covered in 2007-08, the SCVPD has recommended the inclusion of "children aged 2 to 5 years" on top of the existing group of "children aged 6 to 23 months" so as to reduce their hospital admissions. Meanwhile, the SCVPD has also proposed that "persons with chronic neurological condition, whose respiratory function is compromised or who lack the ability to care for themselves" be included in the group of "patients with chronic illness". In other words, the SCVPD has recommended that this group of patients to receive influenza vaccination.
Our vaccination policy is devised on the basis of scientific evidence. Though a vaccine can help reduce our risk of contracting infectious diseases, at the same time, it may also pose certain risks such as side effects and adverse reactions. We are studying the recommendations of the SCVPD seriously and will carefully consider how best the target groups recommended by the SCVPD should be vaccinated.
The total number of "children aged 2 to 5 years" plus "children aged 6 to 23 months" as previously recommended by the SCVPD is about 330 000. While parents have the right to decide whether to let their children receive influenza vaccination, we hope that by putting in place some measures, we can encourage parents and facilitate them to take their children at the appropriate age to receive the vaccination.
While the provision of influenza vaccination at government clinics is surely one of the feasible options, we are also considering other alternatives, for example, the provision of a fixed subsidy to encourage children aged 6 months to 5 years to receive influenza vaccination at private clinics. This can help promote the participation of private doctors in the provision of preventive healthcare and it is also in line with the Government's policy direction of establishing a family doctor system and fostering public-private partnership in the provision of healthcare services.
However, the implementation of such a subsidy scheme requires comprehensive planning and must be in compliance with some basic principles, including: the targets of government subsidies are children who receive vaccination rather than private doctors; the pricing of vaccination service provided by private doctors should be based on the price of vaccine plus a reasonable fee for inoculation service; the pricing should be transparent and reasonable to enable the public to make an informed choice; participating private doctors are required to register with the Government beforehand, store the information and statistics relating to the vaccination properly, including children's names, addresses, schools, etc., and furnish the Government with relevant information for verification and surveillance purposes.
We, together with DH, are holding discussions with private doctors and the departments concerned to look into the details of this subsidy scheme. Depending on the outcome of our discussions, we do not rule out the possibility that in the end the Government will provide the vaccination service for the children. Our aim is to provide a subsidy for children aged 6 months to 5 years to receive influenza vaccination during this year's influenza season.
Ends/Wednesday, June 18, 2008
Issued at HKT 11:54
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