A child is vaccinated in Binh Duong province. (Photo: VNA)This comes as the vaccination rate for the Expanded Programmeon Immunisation (EPI) fell short of the annual targets last year.
In 2022, only three out of 20 provinces and cities in thesouthern region achieved the full vaccination rate for children underone year old, and the overall vaccination rate for the region reached only79.5% due to the vaccine shortage in the EPI.
According to Hoang Ngoc Mai, thanks to reserves, vaccines werestill adequately supplied in the early months of 2022. However, by mid-2022,the supply was not quickly replenished, leading to a shortage of a number ofvaccines nationwide for diseases such as measles, DPT(diphtheria-pertussis-tetanus), measles-rubella (MR) and polio(bOPV).
To cope with the shortage, the Institute of Vaccines and MedicalBiologicals, the Centre for Research and Production of Vaccines and MedicalBiologicals sponsored 328,280 doses of DPT vaccine and 200,000 doses of measlesvaccine to the programme, helping to meet the demand for a month.
But shortage has recurred and persisted since then. Due to thelack of vaccines, in 2022, most of the vaccination rates in the EPI did notreach the annual target and had been lower than the 2021 rates.
In the southern region, 14 provinces had vaccination rates below80%, such as Dong Nai, Tien Giang, Lam Dong, Tay Ninh, Can Tho, Soc Trang, AnGiang, Tra Vinh, Dong Thap, Binh Phuoc, Kien Giang, Ca Mau, Bac Lieu and HauGiang.
The catch-up vaccination rate in the southern region was also verylow. In 2022, only 16 out of 20 provinces implemented catch-up vaccination,with 338,026 doses administered.
In the first quarter of 2023, only 18 provinces and citiesconducted catch-up vaccinations, with 123,498 doses administered. This numberis very low compared to the number of children that are in need of catch-upvaccination and does not significantly change the vaccination rate in theregion.
Risk of infectious disease outbreaks
Mai said that the low vaccination rate puts Vietnam at risk oflarge-scale outbreaks of infectious diseases. She noted that the World HealthOrganisation (WHO) has classified the risk of polio returning to Vietnam fromthe lowest level to a medium-high level.
Duong Thi Hong, Deputy Director of the National Institute ofHygiene and Epidemiology under the Ministry of Health, and Head of the NationalExpanded Programme for Immunisation Office, said that currently, most provinceshave run out of the 5-in-1 DPT-VGB-Hib vaccine against diphtheria, whoopingcough, tetanus, hepatitis B, and haemophilus influenzae typeb (Hib).
Some vaccines are in very limited supply and only enough for useuntil July 2023, such as DPT, tuberculosis (BCG), pertussis (DTaP), andmeasles-rubella vaccines.
Meanwhile, the polio vaccine supply is sufficient until August2023. The EPI has compiled all vaccine needs from localities and submitted themto the Ministry of Health.
Hong said that the health ministry is making efforts to restorethe vaccine supply for the programme. The ministry will establish a commonprice framework for imported 5-in-1 vaccines, and localities will quickly signcontracts with manufacturers based on actual needs, after obtaining results ofprocurement through bidding or price negotiation according to regulations,quickly sign the contract to receive the vaccine. This method is similar towhat the Department of Health has done to buy some drugs.
"In June, the ministry will issue an official documentrequesting the quantity of orders," she said.
"Localities must have an accurate figure of the requiredvaccine quantity to avoid situations of excess or shortage compared to thedemand."
HCM City is one of the localities affected by the disruption ofvaccine supply in the EPI due to a large number of children in the vaccinationage group.
According to the city’s Department of Health, the shortage ofvaccines for EPI started in May 2022 and has continued until now.
Despite sending multiple recommendation letters to the healthministry, the quantity of supplied vaccines has not been sufficient to meet thevaccination needs of young children in the area.
According to the projection of the Department of Health, from nowuntil June 2024, HCM City needs approximately 1,553,000 doses of variousvaccines in the EPI.
The EPI is providing immunisation to 10 vaccine-preventablediseases in Vietnam.
It is estimated that EPI has saved 42,000 lives and prevented morethan 6.7 million childhood diseases like polio, tetanus, diphtheria, measlesand pertussis with high vaccine coverage.
Cubersome procedures slow down supply
Nguyen Dang Hien, Director of the Centre for Research andProduction of Vaccines and Medical Biologicals, which is currently responsiblefor producing and supplying four types of vaccines for the EPI (including bOPV,measles, and measles-rubella), said that in previous years, there was noshortage of vaccines because the centre would usually produce a certain surplusquantity of vaccines for future years, even without specific plans or orders.
However, in the past two years, due to changes from the Ministryof Health, the centre no longer produces a surplus but manufactures vaccinesbased on specific orders.
Recently, the centre received a document from the health ministryregarding the proposal of pricing plans, which will be submitted to theministry for approval.
Based on the approved prices by the health ministry, the EPI willsign a joint contract to purchase vaccines, and provinces and cities will placespecific orders with the manufacturers accordingly.
However, in order to accomplish this, the manufacturer needsan accurate quantity to determine the vaccine price and forecast the rawmaterials for production planning.
In addition to the quantity, localities need to provide themanufacturer with the delivery schedule, such as how many times a year theywill receive shipments and when they will receive them, so that the company canhave appropriate production plans.
"The vaccine supply is not something that can be instantlyfulfilled, we need to have a plan to prepare for purchasing raw materials. Onlywith accurate forecasting and ordering can we ensure the domestic vaccinesupply," said Hien.
Agreeing with this, Tran Thanh Hieu, Deputy Director of the state-ownedCompany for Vaccine and Biological Production No.1 (VABIOTECH),said that the Ministry of Health and the EPI need to be proactive in placingorders so that companies can be proactive in production and supply.
Hieu said, like the Centre for Research and Production of Vaccinesand Medical Biologicals, in previous years, VABIOTECH had produced a certainquantity of vaccines for stockpiling, ready to supply when needed. However, dueto various objective conditions, the unit is currently unable to produce alarge quantity.
Therefore, if the health ministry and localities have plans andplace orders early, the enterprise can respond in a timely manner.
"To ensure a steady and sustainable supply, it is necessary tohave a long-term plan, at least two years, so that the entire programme,manufacturers, and users can be proactive," said Duong Huu Thai, Directorof the Institute of Vaccines and Medical Biologicals (IVAC), which has providedfour types of vaccines for the EPI./.
VNA
