Replies to LegCo questions
LCQ7: Childhood immunisation programme
Following is a question by the Dr Hon Yeung Sum and a written reply by the
Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council
today (May 23):
Question:
Regarding the immunization service provided by the Department of Health, will
the Government inform this Council:
(a) of the morbidity rate of streptococcus pneumoniae disease and meningitis in
Hong Kong; the countries which have included the vaccines against these two
diseases in their national immunisation programmes; the respective estimated
cost and cost-effectiveness of including each of these two vaccines in the
Childhood Immunisation Programme (CIP);
(b) whether it will consider including the above two vaccines in CIP; if it
will, of the details; if not, the reasons for that; and
(c) when vaccine against hepatitis B was first included in CIP; the estimated
number of people in Hong Kong who have not been inoculated with such vaccine;
whether it will consider inoculating these people with such vaccine; if it will,
of the details; if not, the estimated number of new cases of hepatitis B in Hong
Kong in the coming five years and the medical expenses to be incurred?
Reply:
Madam President,
(a) The incidence rate of invasive pneumococcal diseases in Hong Kong was
reported to be 2.3 per 100 000 population, as compared with 24 per 100 000
population in the United States before the introduction of pneumococcal vaccine
there.
Locally, the annual incidence of invasive meningococcal infections was between
0.03 and 0.21 per 100 000 population in 1990-2006, as compared with 0.8-1.3 per
100 000 population in the United States before the introduction of meningococcal
vaccine there.
Some of the countries that have included or not included pneumococcal and
meningococcal vaccines in their childhood immunisation programmes are shown in
Table 1.
The cost of including the vaccines into the childhood immunisation programme
depends on various factors, such as the type of vaccine used, the mode of
vaccination and the supply and demand of the vaccines. It is difficult to
estimate the related cost at present.
(b) The Department of Health (DH) receives advice from the Scientific Committee
on Vaccine Preventable Diseases (the Committee) under the DH's Centre for Health
Protection in updating the childhood immunisation programme of Hong Kong. The
Committee regularly reviews the local epidemiology of diseases, scientific
development and application of new vaccines as well as their formulations and
cost-effectiveness, and the experiences of other health authorities in making
recommendations to the DH.
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 2. Therefore, the Committee
concludes that there are insufficient justifications to include the quadrivalent
meningococcal vaccine in the Childhood Immunisation Programme of Hong Kong.
Taking the Committee's recommendation, the Administration has no plans to
introduce meningococcal vaccine into the local childhood immunisation programme.
Inclusion of vaccines against invasive pneumococcal diseases in the Childhood
Immunisation Programme for new born babies and the cost effectiveness of such a
programme are being reviewed by the Committee.
(c) Hepatitis B is a type of viral hepatitis that leads to acute hepatitis.
Infected people may also develop a carrier state, which is associated with
chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. The risk of
carriage varies with the age of infection. It occurs in 90-95% of infants
infected by perinatal transmission (mother-to-child transmission at or around
the time of delivery), 30% of children aged 1 to 5, and 5-10% of the youth and
adults.
The hepatitis B virus is found in the body fluids of an infected patient or a
carrier. It is mainly spread through perinatal, blood or sexual contact.
Perinatally acquired hepatitis B infection was regarded as the most important
cause of the high carrier rate in Hong Kong.
In Hong Kong, hepatitis B vaccine has been incorporated into the Childhood
Immunisation Programme for newborn babies since 1988 to cover all children born
since January 1986. Babies get the immunisation at birth in hospitals, followed
by immunisations at Maternal and Child Health Centres at one and six months of
age. Besides, inoculators of the DH also pay annual visits to all primary
schools and check the immunisation status of school children. Those who have not
been immunised with the hepatitis B vaccine previously will be immunised. The
vaccination coverage rates have been maintained at more than 98% at both Primary
1 and 6 in the past 10 years. Therefore, the majority of the people aged 21 or
below are immunised against hepatitis B infection.
Acute hepatitis B infection is one of the statutorily notifiable diseases in
Hong Kong. The annual number of acute hepatitis B notified in the past 5 years
was about 98-130. The breakdown is shown in Table 2.
We expect that the number of new cases in the next few years would be within
this range.
As the clinical presentations of hepatitis B infection may range from
asymptomatic, acute hepatitis, chronic hepatitis, cirrhosis and liver caner, it
is difficult to estimate the medical expenses.
Ends/Wednesday, May 23, 2007
Issued at HKT 12:23
NNNN
Tables on LCQ7