Following is a question by the Hon Lai Tung-kwok and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (October 22):

Question:

     It is learnt that in recent years, many countries or regions have strongly encouraged elderly persons and patients with chronic diseases to receive the herpes zoster (commonly known as shingles) vaccine (the vaccine). In its reply to a question raised by a Member of this Council on the 8th of this month, the Government indicated that the Health Bureau had commissioned the University of Hong Kong to conduct a cost-benefit analysis of the vaccine, and that the Scientific Committee on Vaccine Preventable Diseases (SCVPD) was expected to discuss matters relating to the administration of the vaccine next year at the earliest, upon completion of the analysis. In this connection, will the Government inform this Council:

(1) of the details of various existing government-subsidised and free vaccination programmes, and the respective number of beneficiaries and expenditure for various programme over the past five years;

(2) whether it knows if any subsidised or free vaccination programmes for the vaccine are currently available in Macau and other neighbouring regions of Hong Kong; if it knows such subsidies are available, of the details; whether the authorities have introduced any other targeted measures to protect immunocompromised individuals from infection by highly transmissible epidemic diseases; if so, the details of those measures; if not, the reason for that;

(3) of the authorities' estimate as to how long SCVPD will take, after commencing its discussions, to decide whether to include the vaccine in the Government Vaccination Programme; and

(4) given that it will take time for SCVPD to reach the decision mentioned in (3), whether the authorities have considered including the vaccine in the Hospital Authority Drug Formulary as a free or subsidised item, and administering it by injection to cancer patients undergoing chemotherapy and to patients with immune system diseases, in order to reduce their risk of contracting herpes zoster or alleviate the resultant suffering after contracting herpes zoster?

Reply:

President,

     Herpes Zoster (also known as Shingles) is caused by varicella-zoster virus, which is also responsible for Chickenpox. The virus remains latent in the nervous system of patients recovered from Chickenpox and may reactivate in times of weakened immune system many years later, inducing Herpes Zoster. Therefore, Herpes Zoster is not a disease caused by acute infection. Patients would develop painful, belt-like skin rash with blisters. Herpes Zoster is not serious in general and the risk of serious complications or death is not high. Early treatment with antiviral medications can speed up the healing of blisters, reduce the symptoms and the risk of complications.

     The position paper on Herpes Zoster vaccine published by the World Health Organization (WHO) in July this year pointed out that recombinant Herpes Zoster vaccine is effective in preventing Herpes Zoster, and its common side effects include pain, redness and swelling at injection site, headache, fever, chills, muscle ache, fatigue. For vaccines not included in the Government's subsidised immunisation programmes, individuals can consult their family doctor for professional advice to understand the benefits, risks and need for vaccination. Based on a doctor's assessment of health status, medical history, and other factors, individuals can make informed decisions on whether to proceed with vaccination under informed consent.

     In response to the Hon Lai Tung-kwok's question, the reply after consultation with the Department of Health (DH) and the Hospital Authority (HA) is as follows:

(1) The regularised vaccination programmes implemented by the DH, including Seasonal Influenza (SI) Vaccination Programme/Pneumococcal Vaccination Programme, provide free or subsidised SI vaccination and pneumococcal vaccination services to eligible persons. Besides, the DH provides free vaccination services for eligible children under the Hong Kong Childhood Immunisation Programme (HKCIP) for the prevention of 12 communicable diseases with public health significance, namely tuberculosis, hepatitis B, poliomyelitis, tetanus, pertussis, measles, diphtheria, mumps, rubella, varicella, pneumococcal disease and human papillomavirus infection.

     The vaccination statistics of the aforementioned regularised vaccination programmes, and the expenditure on the SI vaccine and the pneumococcal vaccine in the past five years are provided at Annex. The expenditure on the HKCIP is dispersed across multiple cost components and hence cannot be separately identified.

(2) According to our understanding, neither the Chinese Mainland nor the Macao Special Administrative Region is offering subsidised or free Herpes Zoster vaccination programmes. The Chinese Center for Disease Control and Prevention suggests that if vaccination is needed, citizens can consult local vaccination clinics and get vaccinated voluntarily at own expense.

     The Government encourages the public, especially immunocompromised individuals to remain vigilant. Members of the public, who experience symptoms, should seek medical advice early and take medications according to doctors' instructions. Antiviral drug can shorten the recovery time of Herpes Zoster patients with symptoms and it is optimal to take it within three to five days of the onset of the disease. At the same time, the Government is committed to enhancing district-based primary healthcare services to shift the emphasis of the present healthcare system and mindset from treatment-oriented to prevention-oriented. Initiatives include promoting the Life Course Preventive Care Plan through District Health Centres to formulate personalised health management plans that address the health needs of citizens across different life stages, based on personal factors such as their gender, age and family history. Through family doctors and primary healthcare professionals, the Government provides advice and education on chronic disease and cancer screenings, as well as on healthy lifestyle habits, to promote the overall health of citizens. The Government also reminds the public that maintaining a healthy lifestyle, including a balanced diet and regular exercise, can help strengthen immunity and prevent Herpes Zoster.  

     Citizens should take primary responsibility for managing their own health and should consider whether to take a particular preventive measure from personal health angle thoroughly. From the perspective of healthcare policy, the use of public funds for subsidising such a measure must be based on public health grounds and a consideration of the pros and cons.

(3) The University of Hong Kong is conducting a cost-effectiveness analysis on the Herpes Zoster vaccine as commissioned by the Health Bureau, with the report expected to be completed by 2026. Upon receiving the report, the Scientific Committee on Vaccine Preventable Diseases (SCVPD) under the Centre for Health Protection of the DH will review the findings. The SCVPD will make local vaccination recommendations on Herpes Zoster vaccine from a public health angle in accordance with scientific evidences, the local epidemiological situation, the latest recommendations of the WHO and overseas experiences, etc.

     Even if the SCVPD recommends the Herpes Zoster vaccine for specific high-risk groups in future, the Government will also have to carefully consider various factors, including the overall medical burden of the disease on the community, public acceptability, vaccine availability and procurement situation, and other public health factors. Therefore, it is premature at this stage to speculate on whether the vaccine will be included in the Government's vaccination programme or to discuss the timeline of making such a decision.

     Individuals can consult their family doctors for professional advice on the benefits, risks and necessity of Herpes Zoster vaccine as personal protection. The Government is also committed to enhancing district-based primary healthcare services. Family doctors and primary healthcare professionals will closely collaborate to provide information and education on vaccinations (including the Herpes Zoster vaccine), to enhance public awareness of the Herpes Zoster vaccine and preventive consciousness.

(4) Currently, Herpes Zoster vaccination is not included in the HA's treatment protocols for solid tumour cancer patients undergoing chemotherapy. The HA will continue to closely monitor the latest recommendations issued by the SCVPD and whether the Herpes Zoster vaccines are incorporated into the Government's subsidised immunisation programme, in order to make appropriate arrangements.

Ends/Wednesday, October 22, 2025
Issued at HKT 16:55

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