Measles Vaccination System in Need of Revamp05-20 00:00 《财经》杂志
By staff reporter He Tao and intern Xie Yingzi
A measles epidemic spread throughout China in the first four months of the year. From Jan. 2014 to the end of April, 25,000 new cases of measles were reported, which is more than four times the number cases reported in all of 2012. Beijing, which has a strong track record in disease control work, reported 1,500 cases as of May 4.
Measles is a highly contagious acute respiratory infection which, if complicated by other diseases such as pneumonia and encephalitis embolism, can endanger the lives of patients. The disease is included in the World Health Organization’s (WHO) elimination program, which aims to wipe out measles in the Americas by 2010 and Europe by 2015. The WHO aimed to eliminate measles in the Western Pacific region, which China is a part of, by 2012. Up to now, indigenous measles transmission has been stopped in all of North and South America; however, the same cannot be said of the Western Pacific region.
“Eliminating” measles means bringing the incidence of the disease down to extremely low levels, i.e., one case per million population or less. China has a population of 1.3 billion people, meaning that new cases of measles should be controlled to within 1,300 people each year.
Measles is transmitted from human to human, which means that as long as a certain percentage of a population is vaccinated and an immunologic barrier is formed, the measles virus can be effectively eliminated. WHO guidelines recommend vaccinating more than 95 percent of children with a two-dose vaccine.
China has widely implemented a two-dose measles vaccination strategy since 1985. If this is the case, then why have the results been so lackluster? WHO China’s Dr. Lance Rodewald, team leader of its Expanded Program on Immunization, told Caijing that this indicates the vaccination rate of the two-dose vaccine is not high enough to block the spread of the virus. In other words, routine vaccination work at the grassroots level has not been done well.
A Center for Disease Control (CDC) worker in Sichuan Province said that while the CDC reports its vaccination rates are higher than 95 percent, “this is simply not accurate.”
Many people born in the 1960s-1980s were either not vaccinated or vaccinated ineffectively, giving them low immunity to the virus. Tao Lina, managing physician of Immunization Planning Division at the Shanghai CDC, said that in the early years of administration, the measles vaccine was only valid for three months. This, coupled with weak transport and refrigeration capability at that time, made it difficult to keep the vaccine refrigerated at the required 2-8 degrees Celsius, which in turn rendered the vaccine ineffective in many cases. In addition, the dosage level of the early measles vaccine was low, only 14 percent of what it is now, and drop-out cases were quite common.
Every year from March to May, Beijing provides free measles vaccinations to migrant workers under the age of 40, and gives their children under six years of age free supplementary vaccinations.
However, such an approach is still missing policy support. The description of the existing measles vaccine makes no mention of adult vaccinations and states only that children aged 8 months to 14 years can be vaccinated. With this omission, if an adult were to have an adverse reaction to the vaccine, it would be difficult to identify responsibility.
Full article in Chinese:http://magazine.caijing.com.cn/2014-05-19/114191654.html
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