Under the Elderly Vaccination Subsidy Scheme (EVSS), elderly persons (i.e. persons aged 65 or above) who are eligible can get a subsidy of HK$190 for receiving 23-valent polysaccharide pneumococcal vaccination at the clinics of private medical practitioners enrolled in EVSS. Nevertheless, it has been reported that among the 7 502 persons who died from pneumonia in Hong Kong in 2014, as many as 7 072 were elderly persons; and pneumonia has surpassed heart disease as the second killer disease in Hong Kong. Some medical practitioners have pointed out that the United States Centers for Disease Control and Prevention (CDC) have recommended the provision of the 13-valent pneumococcal conjugate vaccine (PCV13) for elderly persons, which utilises new conjugation technology and offers long-term protection. In addition, the Centre for Health Protection launched a one-off measure in March 2015 to allow eligible elderly persons who had never received pneumococcal vaccination before to be vaccinated with the remaining stock of PCV13 of the “Childhood PCV13 Booster Vaccination Programme”. As at February 2015, the remaining stock of such vaccines amounted to some 3 400 doses, and about one-third of which could be utilised until the end of May 2015, while the rest could be utilised until the end of October 2015. In this connection, will the Government inform this Council:
(1) of the number of elderly persons who received vaccination of the aforesaid remaining stock of PCV13, and the percentage of such number in the total number of elderly persons; among the remaining stock, of the quantity of vaccines which were discarded as they had expired;
(2) whether it knows the supply situation of PCV13 in Hong Kong last year;
(3) whether it has plans to switch to adopt PCV13 as the pneumococcal vaccines under EVSS, and procure additional doses of such type of vaccines in order to ensure a sufficient supply of vaccines; if it does not have such plans, of the reasons for that;
(4) given that the number of fatal geriatric cases of pneumonia has been continuously rising in recent years, whether the authorities will consider providing elderly persons with free vaccination of PCV13; if they will, of the details; if not, whether other effective measures are in place to reduce the number of such fatal cases; and
(5) whether it has considered regularly updating the guidelines for EVSS, reviewing the effectiveness of the vaccines under EVSS and using more effective vaccines to enhance the elderly’s resistance against pneumonia, with reference to international experience and recommendations (e.g. the aforesaid recommendation put forward by CDC); if it has, of the details; if not, the reasons for that?
Pneumonia is an acute respiratory infection of the lungs caused by pathogens like viruses, bacteria and fungi. Pneumococcus is one of the bacteria that cause pneumonia. Pneumococcal vaccination is one of the safe and effective means of preventing pneumococcal diseases. All along, the Department of Health (DH) has been implementing pneumococcal vaccination programmes with reference to the recommendations of the Scientific Committee on Vaccine Preventable Diseases (SCVPD) under the Centre for Health Protection (CHP). As far as elderly persons are concerned, the following regular vaccination programmes have been implemented by the DH since October 2009, in accordance with the recommendation of the SCVPD, to give eligible elderly persons 23-valent pneumococcal polysaccharide vaccine (23vPPV):
(i) Government Vaccination Programme (including the Residential Care Home Vaccination Programme) which provides free pneumococcal vaccination for eligible elderly persons aged 65 or above; and
(ii) Elderly Vaccination Subsidy Scheme which provides subsidised pneumococcal vaccination for elderly persons aged 65 or above through participating private doctors.
For children, the Government has also implemented regular programmes to provide free vaccination. Currently under the Hong Kong Childhood Immunisation Programme, free doses of 13-valent pneumococcal conjugate vaccine (PCV13) are given to eligible children at two, four and six months of age, followed by a booster dose at 12 months of age, at the DH’s maternal and child health centres. My reply to the various parts of the question is as follows.
(1) About 382 000 elderly persons aged 65 or above have received 23vPPV vaccination through the Government Vaccination Programme (including the Residential Care Home Vaccination Programme) or the Elderly Vaccination Subsidy Scheme, accounting for about 34 per cent of persons in that age group. The above two regular vaccination programmes, which eligible elderly persons may join any time throughout the year, are part of the long-term and sustained measures taken by the Government to prevent pneumonia.
In addition, as a separate one-off measure, the Government carried out the Childhood PCV13 Booster Vaccination Programme by phases between December 2013 and October 2015. Children aged two to below five who had never had PCV13 vaccination could receive one dose of PCV13 as a personal health protection if needed. More than 23 000 doses of PCV13 were administered under the programme, and there were about 3 000 doses of unused vaccines. For better utilisation of resources, the DH implemented another one-off measure from March to October 2015 to vaccinate eligible elderly persons who had never received pneumococcal vaccination by using the remaining 3 000 or so unused doses of PCV13 of the booster vaccination programme. About 700 eligible elderly persons received the PCV13 vaccination in the period. At the end of the booster vaccination programme in late October 2015, about 2 300 doses of expired PCV13 in stock were discarded.
(2) At present, two types of PCV13, namely Prevenar 13 Vaccine (registration number: HK-59600) and Prevenar 13 Vaccine suspension for injection (registration number: HK-62449), are registered pharmaceutical products approved by the Pharmacy and Poisons Board of Hong Kong. The DH has entered into contracts with the vaccine suppliers to ensure an adequate supply of vaccines for the vaccination programmes.
The DH keeps in view the supply of vaccines and maintains close liaison with the vaccine suppliers. In 2015, the DH did not receive any reports of vaccine shortage in the public and private sectors.
(3) to (5) On the latest development of pneumococcal vaccines, the SCVPD has met to examine the relevant scientific evidence and discuss the use of pneumococcal vaccines. The updated recommendations will be uploaded to the CHP website once available. The DH will continue to monitor the pneumococcal vaccination figures, coverage of vaccination programmes and occurrence of pneumonia among elderly persons and pay close attention to the SCVPD’s recommendations and the latest development in reviewing the arrangement of pneumococcal vaccination for the elderly, including whether PCV13 should be incorporated into the Government Vaccination Programme (including the Residential Care Home Vaccination Programme) and/or the Elderly Vaccination Subsidy Scheme.
The DH has all along been strengthening the promotion of pneumococcal vaccination for the elderly through various channels, including media sessions and press releases timed to coincide with the re-launch of the Elderly Vaccination Subsidy Scheme and Government Vaccination Programme every year, briefings for staff of residential care homes for the elderly and healthcare workers, and information materials and promotional posters distributed to elderly centres, public housing estates and management companies of private buildings. Up-to-date information about pneumococcal vaccination can also be downloaded from the CHP website.
While pneumococcal vaccination can be a way to prevent pneumococcal diseases, good personal and environmental hygiene is also important. People having symptoms of respiratory infection should wear a mask and consult a doctor. Use of appropriate antibiotics can treat pneumococcal infections.