Replies to LegCo questions
LCQ11: Seasonal influenza vaccines
Following is a question by the Dr Hon Kwok Ka-ki and a written reply by the
Acting Secretary for Food and Health, Professor Sophia Chan, in the Legislative
Council today (February 25):
Question:
The Department of Health currently implements the Seasonal Influenza Vaccination
Programme and the Pneumococcal Vaccination Programme, but it has not implemented
a similar programme for cervical cancers. The first aforesaid Programme includes
the Childhood Influenza Vaccination Subsidy Scheme (CIVSS), the Elderly
Vaccination Subsidy Scheme (EVSS), the Childhood Vaccination Subsidy Scheme
(PCV13 booster) (PCV13SS) and the Residential Care Home Vaccination Programme
(RVP). Members of the public may receive influenza vaccination from private
doctors who have enrolled in CIVSS and EVSS and be entitled to a subsidy of $160
per dose of such vaccine. Under the RVP, the authorities will provide free
vaccines and reimburse registered medical doctors a $50 injection fee per dose
of vaccine. However, residential care homes (RCHs) need to make arrangements on
their own for registered medical doctors enrolled in the programme to provide
vaccination to residents, boarders and staff at their respective RCHs. In this
connection, will the Government inform this Council:
(1) of the details of the publicity efforts made by the authorities since the
onset of the current influenza season through the mass media to arouse public
awareness of the prevention of the influenza epidemic and the aforesaid
vaccination programmes, including (i) the publicity channels, (ii) the publicity
frequency, (iii) the expenditure involved, and (iv) the percentage of the air
time for the broadcast of television announcements in the public interest (TV
APIs) on influenza prevention in the total air time for the broadcast of
government TV APIs during the period;
(2) whether it knows the respective vaccine costs and injection costs per dose
of trivalent and quadrivalent influenza vaccines;
(3) of the respective number of people who received trivalent and quadrivalent
influenza vaccines in the past five years under (i) CIVSS, (ii) EVSS and (iii)
RVP and the expenditure involved; the respective numbers of private medical
doctors/clinics enrolled in such programmes since their introduction; whether
the authorities will step up publicity efforts to attract more private medical
doctors to enrol in such programmes; whether the authorities will increase the
amount of subsidy per dose of vaccine and simplify the application procedures to
attract more members of the public/RCHs to participate in such programmes (and
set out the information by programme);
(4) of the number of children who received vaccination under PCV13SS since the
implementation of the scheme and the expenditure involved; the number of doses
of 13-valent pneumococcal conjugated vaccine provided by the Government which
are still unused at present; whether the authorities will step up publicity
efforts to attract more parents to arrange for their children to participate in
the scheme, and whether they will extend the implementation period of the
scheme;
(5) given that the influenza epidemic in the current influenza season is more
severe than that in previous years and there were already more than 200
influenza-associated deaths, whether the authorities will expeditiously allocate
additional resources to the various aforesaid vaccination programmes for
stepping up publicity efforts, procurement of additional doses of vaccines, and
requesting the Hospital Authority to provide vaccination services in various
public hospitals; if they will, of the details;
(6) whether it knows the respective percentages of children aged under six,
elderly people (i.e. those aged 65 or above) and elderly people suffering from
chronic illnesses who received vaccination in the past five years; whether the
authorities have made reference to the relevant percentages in the neighbouring
regions such as Taiwan, Japan and the Mainland and, in response to the severity
of the recent influenza epidemic, introduce more subsidised vaccination
programmes to enhance protection of public health;
(7) of the number of people who received vaccination under the Pneumococcal
Vaccination Programme in the past five years and the expenditure involved, as
well as the current percentage of the Hong Kong population who has received
vaccination; and
(8) whether it has plans to introduce new programmes to provide free or
subsidised cervical cancer vaccination service for the public; if it does, of
the details; if not, how the authorities protect the public from the threat of
cervical cancer?
Reply:
President,
The Scientific Committee on Vaccine Preventable Diseases (SCVPD) of the Centre
for Health Protection (CHP) recommended nine priority groups for seasonal
influenza vaccination in the 2014/15 season. People in these priority groups are
generally at increased risk of severe complications or even death caused by
influenza or transmitting influenza to those at high risk. Hence, the Government
provides free or subsidised seasonal influenza vaccination to some people in
these high risk groups through the Government Vaccination Programme (GVP) and
the Vaccination Subsidy Scheme (VSS). The Administration also recommends those
people who are not covered by the above schemes to consult their family doctors
and consider receiving seasonal influenza vaccination for personal protection.
The Government will consider the recommendations of the SCVPD and review the
implementation of the GVP and VSS, including their coverage, etc.
Regarding the different parts of the question, my replies are as follows:
(1) The CHP has produced a variety of health education materials on prevention
of influenza including a thematic web page, television (TV) and radio
announcements in public interests (APIs), guidelines, pamphlets, posters,
booklets, frequently asked questions and exhibition boards. Various publicity
and health education channels e.g. websites, TV and radio stations, health
education hotline, newspapers and media interviews have been deployed for
promulgation of health advice. The CHP also launched a dedicated Facebook Page
and a YouTube Channel in February 2015, with a view to further disseminating
information on health promotion as well as disease prevention and control to
members of the public, especially the younger generation.
In addition, the CHP has also widely distributed health education materials in
public and private housing estates, healthcare settings, schools and
non-governmental organisations (NGOs), etc. The CHP also keeps the stakeholders
including government bureaux and departments, hotel and guesthouse associations,
property management associations, Hong Kong Housing Society, District Councils,
Healthy Cities Projects, NGOs and ethnic minority groups updated of the latest
influenza activity and preventive measures to solicit their co-ordination and
support to strengthen the publicity of related health messages.
From November 1, 2014 to February 22, 2015, a total of 25 media interviews were
conducted by CHP. Nine APIs related to the prevention of influenza, avian
influenza, vaccination schemes and general health advice were broadcast with a
total of 4,399.5 minutes of TV air time or 8,799 slots allocated. The APIs have
been aired on a total of 40 channels operated by five TV stations. The air time
used represents 5.96% of all TV API free air time during that period.
Corresponding API versions were also aired on radio. To enhance publicity,
selected APIs are also being broadcast on public transport.
The Government has arranged a series of publicity activities in the 2014/15
season to promote vaccination, in particular to the targeted high risk groups.
Four press conferences were held in August, September, October and November 2014
respectively to encourage Hong Kong residents to receive seasonal influenza
vaccination. As local surveys found that professional advice was effective in
promoting vaccination, relevant experts were engaged in various publicity
activities to promote vaccination to different target groups. Experts from the
SCVPD, Hong Kong Academy of Medicine and five specialist colleges also came
together to announce a Consensus Statement regarding the importance of seasonal
influenza vaccines (SIV). Besides, specialists attended media interviews to
explain the benefits and the necessity of receiving seasonal influenza
vaccination. Moreover, publicity was done through APIs in mass media;
advertisements on the MTR, public buses, newspapers, magazines and on-line apps;
promotion on websites; and collaboration with community partners, District
Councils and NGOs to encourage vaccination.
The expenditure on the publicity and public education on the prevention of
influenza cannot be separately identified as it is absorbed as part of the
overall expenditure for health promotion under the Department of Health (DH).
(2) The amount of subsidy for each dose of SIV under the VSS has been increased
from $130 to $160 in the 2014/15 season, covering the vaccine cost and injection
cost. The DH has made reference to the market prices of SIV supplied to the
private sectors to determine the amount of subsidy. As services offered by
different private doctors may vary, the Government will not set restrictions on
or mandate a fixed fee. Participating doctors are however requested to set out
the additional service charge on the price poster and on the CHP website so that
the public may make an informed choice.
(3) There are more than 1,600 private doctors, involving over 2,200 clinics,
enrolled under the Childhood Influenza Vaccination Subsidy Scheme (CIVSS) and
the Elderly Vaccination Subsidy Scheme (EVSS) in 2014/15. Before the launch of
these subsidy schemes every season, the DH would issue letters to all registered
private doctors in Hong Kong inviting them to enrol in these two subsidy schemes
and organise briefing sessions for them. For the Residential Care Home
Vaccination Programme (RVP), the DH would also issue letters to all registered
Residential Care Homes (RCHs) for the Elderly and RCHs for Persons with
Disabilities inviting them to enrol in the RVP. More than 90% of the RCHs enrol
in the RVP every year.
The enrolment application procedures for these programmes have all along been
very simple and convenient. Relevant information and application details have
been uploaded onto the CHP website. Interested doctors can enroll in these
programmes anytime.
CIVSS and EVSS
The subsidised vaccine in these two subsidy schemes up till the 2013/14 season
was trivalent SIV; and quadrivalent SIV is also included as the subsidised
vaccine in these schemes in the 2014/15 season. Among the some 2,200 clinics
enrolled under the VSS, around 1,400 of them provide quadrivalent SIV.
The number of persons receiving vaccination and the expenditure in the past five
seasons are as follows:
CIVSS
No of Persons Expenditure
(in million dollars)
2010/11 49,000
4.63
2011/12 44,000
4.24
2012/13 60,000
10.53
2013/14 62,000
10.66
2014/15# 53,000
10.29
(#as at February 15, 2015)
EVSS
No of Persons Expenditure
(in million dollars)
2010/11 111,000
14.37
2011/12 121,000
15.73
2012/13 142,000
18.46
2013/14 160,000
20.80
2014/15# 174,000
27.84
(#as at February 15, 2015)
RVP
Trivalent SIV was used in the programme up till 2013/14 season. In the 2014/15
season, all vaccines used under the programme are quadrivalent SIV instead. The
number of administered doses and the expenditure in the past five seasons are as
follows:
No of Administered Doses Expenditure*
(in million dollars)
2010/11 65,000
3.3
2011/12 70,700
3.5
2012/13 72,000
3.6
2013/14 72,600
3.6
2014/15# 72,100
3.6
(#as at February 15, 2015)
*Figures include the subsidies for injection cost only.
(4) Since the launch of Childhood 13-valent Pneumococcal Conjugate Vaccine
(PCV13) Booster Vaccination Programme, more than 23,200 eligible children have
received booster doses of PCV13. Among them, 21,600 eligible children received
subsidised booster doses of PCV13 under the Childhood Vaccination Subsidy Scheme
(PCV13 booster) (CVSS(PCV13 booster)) involving subsidies amounting to around $1
million dollars. Though the CVSS(PCV13 booster) ended on June 30, 2014, for
better utilisation of the remaining vaccines, enrolled doctors who have not yet
used up the PCV13 supplied by the Government may continue to provide subsidised
vaccination to eligible children until the PCV13 expire. As at February 8, 2015,
enrolled doctors still have around 3,400 government-supplied PCV13 in hand.
Besides, in order to optimise vaccine utilisation, the Government announced a
one-off measure in February 2015 to allow enrolled doctors, with effect from
March 2, 2015, to provide the remaining doses of government-supplied PCV13 under
the CVSS(PCV13 booster) to eligible elders who have never received Government
subsidised pneumococcal vaccination.
(5) Under the GVP, hospitals of the Hospital Authority (HA) would provide free
influenza vaccination to eligible persons including hospitalised persons
(include hospitalised children) with chronic medical problems, residents of
RCHs, psychiatric elderly patients and long-stay residents of psychiatric
institutions and institutions for the disabled.
In response to the recent demand, the Government has already procure 10,000
additional doses of quadrivalent SIV. The Government has also arranged a series
of publicity activities to promote vaccination, in particular to the targeted
high risk groups, such as:
Early Appeal
Though the 2014/15 VSS and the free GVP were launched in early October and early
November 2014 respectively, the CHP had kick-started the publicity activities as
early as in August 2014 and arranged press conferences to encourage Hong Kong
residents to receive influenza vaccination from time to time.
Collaboration with Medical Experts; Intensive Promotion Drive
As local surveys found that professional advice was effective in promoting
vaccination, relevant experts were engaged in various publicity activities to
promote vaccination to different target groups. Experts from the SCVPD, Hong
Kong Academy of Medicine and five specialist colleges also came together to
announce a Consensus Statement regarding the importance of SIV. Besides,
specialists attended media interviews to explain the benefits and the necessity
of receiving seasonal influenza vaccination.
As for healthcare personnel, the DH, HA and the Hong Kong Private Hospitals
Association jointly conducted a press conference to promote vaccination for
healthcare workers in public and private sectors. Government officials have also
taken the lead to receive vaccination as role models. Moreover, the CHP has
organised briefing sessions for healthcare workers to explain the safety and the
necessity of vaccination.
Multi-channel and Continuous Promotion
The Government has produced a variety of APIs for promulgation on the prevention
of influenza through TV, radio channels, the webpage of Information Services
Department and YouTube channel; placed advertisements in the MTR, public buses,
newspapers, magazines and online apps; arranged promotions on websites and
collaborated with community partners, District Councils and NGOs to encourage
vaccination. Looking ahead, the Government would solicit the help of voluntary
welfare organisations to publicise vaccination education for the targeted
population (such as the elders).
(6) As shown in the survey results on the coverage of seasonal influenza
vaccination conducted by the CHP in the 2012/13 season, 14% of the local
population has received seasonal influenza vaccination, among which the coverage
for children aged six months to five years and elders aged 65 years or above
were 28.4% and 39.1% respectively. The survey results have been uploaded onto
the CHP website.
At present, most needy people of the high risk groups have been covered under
the GVP and the VSS, receiving free or subsidised seasonal influenza
vaccination. To decide whether to further extend the coverage of the influenza
vaccination schemes, the Government has to consider many factors including
scientific evidence, risk factors, resource allocation, etc. The Government will
make reference to the recommendations of the SCVPD and review the free and
subsidised vaccination programmes.
(7) The GVP and the EVSS launched by the Government provide pneumococcal
vaccination to eligible elders aged 65 years or above. The numbers of eligible
elders receiving pneumococcal vaccination under these programmes, provided in
the tables below, account for over 30% of the concerned age group. As some
eligible elders might have received pneumococcal vaccination from other sources
rather than under these programmes, the actual figures are expected to be higher
than those below.
The number of persons receiving vaccination and the expenditure in the past five
seasons are as follows:
Pneumococcal vaccination provided under the EVSS
No of Persons Expenditure
(in million dollars)
2010/11
14,000
2.68
2011/12
14,000
2.65
2012/13
18,000
3.41
2013/14
23,000
4.33
2014/15#
21,000
4.07
(#as at February 15, 2015)
Pneumococcal Vaccination provided under the GVP
No of Persons Expenditure
(in million dollars)
2010/11
16,000
2.37
2011/12
14,000
2.16
2012/13
13,000
1.94
2013/14
14,000
2.04
2014/15#
13,000
1.66
(#as at February 15, 2015)
(8) Regarding Human Papillomavirus (HPV) vaccination, according to the
recommendations jointly issued by the SCVPD and the Scientific Committee on AIDS
and Sexually Transmitted Infections, the Government should consider the local
context and the development of scientific evidence, as well as conduct health
economic evaluation of vaccination programme. The SCVPD has also recommended
strengthening the implementation of the Cervical Screening Progamme in Hong
Kong, raising public awareness and enhancing the public's understanding of the
HPV vaccine through health education and publicity. The Administration will
closely keep in view the latest developments on this subject.
Ends/Wednesday, February 25, 2015
Issued at HKT 18:28
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