Tuesday, 29 March 2016

Illegal vaccine fallout: clinics deserted as public lose confidence; lawyers support patients' rights; failure blamed on 'private market'


The issue of the 2 million substandard vaccines distributed across China continues to make waves in the media and for the government, with some surprising developments.

In a bold move, a group of more than 40 lawyers has written an open letter to the State Council demanding that the government 'protect the public's rights to information and compensation' in regard to the health consequences of the illegal vaccines. In their letter, they pose five questions:
  • How do individuals know if they have received the substandard vaccine?
  • How can people find out whether the vaccine they received was effective, and if necessary the need to re-vaccinate - and who will bear the cost?
  • Why were the public not informed of these risks associated with vaccination?
  • Why did the vaccine quality monitoring system set up in 2006 fail in early warning?
  • For those with vaccine injury, how will this be remedied?
According to Caixin, one of the authors of the letter is Guangdong lawyer and mother of a baby Wang Shengsheng. She herself got one of the suspect vaccines for hepatitis B and was shocked to discover that she may have put her baby at risk.

Wang Shengsheng says she had her baby vaccinated with both essential and non-essential vaccines on the strong recommendation of health authorities and was told they were both necessary and safe. She says she now expects full and prompt disclosure of all results from the investigation, particularly in relation to the batch numbers and locations of the affected vaccines. She says there is also a need for authorities to learn lessons from this scandal so that health consumers can be confident about future treatments and thus have the right to 'informed consent'. This freedom of information should include access to adverse event reports for individual vaccines that are derived from vaccine monitoring programs, she said.

Wang Shengsheng said China also needed a system of compensation for patients with recognised vaccine-related injuries, similar to the system already operating in the US.

Meanwhile, Chinese media outlets such as Sohu Health are reporting that parents are staying away from vaccination clinics as they have lost confidence in the safety and quality of the vaccines being offered.

Reporters who visited community health centres in Guangzhou found them almost empty, and with the few families there expressing concerns about the vaccines being used.

A doctor on duty at a clinic in Tongling said: "Usually at this time we should be full of people. But many parents do not dare vaccinate their children at this time. For the last two days we have been calling people telling them that our vaccines are safe but they are still reluctant to come. They say they are waiting for this matter to blow over."

A doctor at the Zhejiang Tonglu Street Community Health Centre told reporters that they had received dozens of calls from concerned parents asking about the quality and safety of the vaccines they had received. He said parents were still bringing in children to have the essential (Class 1, public funded) vaccines that were not part of the scandal, but use of the Class 2 (private market) vaccines had really dropped.

Doctors at other community clinics were emphasising to worried families that their region's vaccine supplies were on the 'safe list' as they were still part of the public centralised system that had always been well supervised and had not been implicated in purchase of substandard vaccines. They said they were now glad that the vaccine supply and distribution had been kept under control of the government disease control bureau and not 'relaxed' and privatised, as had been the case for many rural counties.

An opinion article in Caixin said the substandard vaccine scandal showed the stark contrast between China's successful and safe public vaccine program and the corrupt and unsafe 'private market' vaccine supply system. The article said the 2006 decision to relax controls on the sale and supply of 'optional' vaccines (Class 2) to allow a free market system had backfired with disastrous consequences for public health.

The article describes how local communicable disease control (CDC) bureaus had been encouraged to 'go to market' to generate extra funds for their own running costs. As with hospitals, these local units had been starved of funding and therefore came to rely on commissions from vaccines to boost their income. This resulted in local CDC bureaus buying the cheapest possible vaccines and charging the maximum markup to patients. It also meant that they strongly recommended non-essential vaccines to families, so that they could make extra profit.

Therefore,  any reform to prevent further substandard vaccine incidents will  need to address the "vaccine commission cash cow" phenomenon as well as ensuring the quality of the vaccine distribution system, it concludes.

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