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Following is a question by the Hon Ip Kwok-him and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (April 20):
Question:
In the first quarter of this year, the Centre for Health Protection recorded more than 200 severe influenza cases. According to the Hospital Authority (HA), there has been an acute demand for public hospital services arising from this winter influenza surge. On the other hand, the Government currently provides, through various schemes, free or subsidised seasonal influenza vaccination (IV) to people in priority groups, mainly young children and the elderly. As at mid-March, about 570 000 people received IV under those schemes, but the population of young children (i.e. aged five or below) and elderly people (i.e. aged 65 or above) was 1.5 million at the end of last year, showing an unsatisfactory vaccination coverage. On enhancing the measures to tackle the next winter influenza season, will the Government inform this Council:
(1) whether it will arrange as early as possible free IV for people in the aforesaid age groups upon the onset of autumn this year, so as to reduce the incidence rate of influenza in the next winter influenza season; if it will, of the schedule; if not, the reasons for that;
(2) given that about 40% of elderly people at present are living in public housing estates, whether the Government will, apart from continuing to implement the Elderly Vaccination Subsidy Scheme, arrange the nursing staff of public or private healthcare facilities to go to various housing estates to provide free IV to elderly residents so as to enhance the coverage; if it will, of the schedule; if not, the reasons for that;
(3) given that under the Residential Care Home Vaccination Programme implemented by the Government, free IV is provided to residents of residential care homes for the elderly and residential care homes for persons with disabilities, whether it knows if there are residential care homes which have been unable to secure any doctor visiting them to provide the relevant vaccination to their eligible residents in 2015-2016; if there are, the reasons for that and the number of residents involved;
(4) whether it will arrange the nursing staff of public or private healthcare facilities to go to all kindergartens in Hong Kong to provide free IV to young children so as to enhance the coverage; if not, of the reasons for that; and
(5) whether it has assessed the annual expenditure on providing free IV comprehensively to all people in the aforesaid age groups, and how such figure compares with HA¡¦s additional expenditure and the social costs incurred by the major outbreak of seasonal influenza during the period from January to March this year?
Reply:
The Scientific Committee on Vaccine Preventable Diseases (SCVPD) of the Centre for Health Protection (CHP) reviews recommendations for seasonal influenza vaccination on a regular basis with reference to local epidemiology and international evidence. In the 2015/16 season, the SCVPD recommended seasonal influenza vaccination for nine priority groups, including elderly persons and children. People in these groups are generally at increased risk of severe complications or even death caused by influenza or spreading the infection to those at high risk. The Government will determine the eligibility of the influenza vaccination schemes after taking into consideration the recommendations of the SCVPD, resource allocation, risks and other factors. The Government currently provides free or subsidised seasonal influenza vaccination to some people of the above groups through the Government Vaccination Programme (GVP), which includes the Residential Care Home Vaccination Programme, and the Vaccination Subsidy Scheme (VSS).
(1) The SCVPD will convene a meeting in July 2016 to provide recommendations on seasonal influenza vaccination for the 2016/17 season. As it takes about two weeks after vaccination for antibodies to develop in the body and provide protection against influenza virus infection, the Government, as usual, plans to commence the 2016/17 influenza vaccination schemes in October this year, so that eligible groups will have ample time to receive vaccination and develop antibodies during the winter influenza season (usually from January to March) for protection.
(2) The Government provides subsidised seasonal influenza vaccination for elderly persons aged 65 or above through private clinics participating in the VSS. Besides, the GVP was expanded in 2015/16 to allow all elderly persons aged 65 or above to receive free seasonal influenza vaccination from the public healthcare facilities, with a view to encouraging more elderly persons to receive vaccination. These measures have proved to be effective. As at April 10, 2016, the two schemes provided about 454,000 doses of influenza vaccination for elderly persons aged 65 or above, representing an increase of 22% over the same period in the previous year and covering 40% of the target elderly population. The Government will regularise the above measures in 2016/17.
At present, the Department of Health (DH) does not have additional manpower to provide outreach influenza vaccination service for all elderly people living in public housing estates. Nevertheless, some private doctors enrolled in the VSS will, in collaboration with different organisations (including elderly centres and non-profit-making organisations), provide outreach vaccination service in the elderly/community centres. If any mutual aid committees of estates or other community organisations are interested in providing subsidised outreach vaccination service for their service users in partnership with private doctors, the DH will provide them with the relevant information and guidelines. The guidelines have also been uploaded onto the CHP¡¦s website for reference. Moreover, the DH will organise briefings for relevant organisations on the details of the VSS (including points to note for provision of outreach vaccination service by private doctors) and distribute posters and leaflets to encourage them to help promote the scheme.
(3) In 2015/16, more than 1,000 residential care homes (RCHs) for the elderly and persons with disabilities have participated in the Residential Care Home Vaccination Programme. This accounted for about 99% of all RCHs in the territory. Some 61,000 doses of seasonal influenza vaccines have been provided for residents in these RCHs, the coverage rate was about 80%. In this year, only seven (about 1%) RCHs for elderly and persons with disabilities did not make arrangement for visits by private doctors to provide on-site vaccination. These seven RCHs involve about 200 eligible persons, including residents and staff. The reasons for these RCHs not to make such arrangements included limited resources and relatively small number of persons eligible for the vaccination. The responsible persons of these RCHs thus encouraged the eligible persons to receive free seasonal influenza vaccination in the public healthcare facilities or subsidised seasonal influenza vaccination from private doctors who have joined the VSS.
(4) Under the Childhood Influenza Vaccination Subsidy Scheme (CIVSS), parents may bring their eligible children (between the age of six months and less than six years, or aged six or above but attending kindergartens or child care centres) to the participating private clinics for subsidised seasonal influenza vaccination. Of over 2,000 private clinics participating in the CIVSS, some do not charge additional service fee on vaccination (i.e. eligible children do not need to pay when receiving vaccination at these clinics). Parents can choose a suitable clinic for vaccination according to their needs. Some participating private doctors also provide outreach vaccination service in collaboration with kindergartens and child care centres.
Moreover, the CHP has noted that some places (e.g. Taiwan and the United Kingdom) have expanded their influenza vaccination schemes to cover primary school students. The Government is making reference to the results of the schemes and considering whether there is a need to expand the CIVSS progressively to provide subsidised influenza vaccination for children aged six to 12.
(5) In 2015/16, the DH purchased about 400,000 doses of influenza vaccines, involving about $21 million.
The increased demand for public healthcare services during the winter influenza season early this year was due to three reasons, namely the overall ageing of patients, diseases (especially among the elderly) caused by the cold weather, the elevation of influenza activities affecting in particular patients with chronic diseases. The Hospital Authority does not maintain information about the additional expenditure incurred by the increased service demand owing to winter seasonal influenza.
In conclusion, vaccination offers us the best protection against infectious diseases through strengthening our immune system. In the future, the DH will continue to maintain communications with stakeholders to collect their views and understand their difficulties, so as to review on the vaccination programmes and fine tune the programme details, and provide reference for preparation of next year¡¦s programmes.
Ends/Wednesday, April 20, 2016
Issued at HKT 19:37
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