关键词: China Non-immunization program Pneumococcal conjugate vaccine Pneumococcal disease Vaccination Vaccination strategy Vaccine-preventable disease

Mesh : Child Humans Infant Child, Preschool Cost-Benefit Analysis Pneumococcal Infections / prevention & control Vaccination Pneumococcal Vaccines Immunization Programs Vaccines, Conjugate China

来  源:   DOI:10.1186/s40249-023-01165-1   PDF(Pubmed)

Abstract:
The World Health Organization (WHO) prioritizes pneumococcal disease as a vaccine-preventable disease and recommends the inclusion of pneumococcal conjugate vaccines (PCV) in national immunization programs worldwide. However, PCV is not included in the National Immunization Program in China and has low vaccination coverage due to its high cost. To address this, Weifang City implemented an innovative strategy for a 13-valent PCV (PCV13) on June 1, 2021. This strategy aimed to provide one dose of PCV13 free of charge for children aged 6 months to 2 years in registered households and to adopt a commercial insurance model with one dose of PCV13 free of charge in 2023 for children over 2 years old. The Health Commission of Weifang and other departments conducted a comprehensive investigation and considered various factors, such as vaccine effectiveness, safety, accessibility, vaccine price, and immunization schedules, for eligible children (under 5 years old). Stakeholder opinions were also solicited before implementing the policy. The Commission negotiated with various vaccine manufacturers to maximize its negotiating power and reduce vaccine prices. The implementation plan was introduced under the Healthy Weifang Strategy. Following the implementation of this strategy, the full course of vaccination coverage increased significantly from 0.67 to 6.59%. However, vaccination coverage is still lower than that in developed countries. Weifang\'s PCV13 vaccination innovative strategy is the first of its kind in Chinese mainland and is an active pilot of non-immunization program vaccination strategies. To further promote PCV13 vaccination, Weifang City should continue to implement this strategy and explore appropriate financing channels. Regions with higher levels of economic development can innovate the implementation of vaccine programs, broaden financing channels, improve accessibility to vaccination services, and advocate for more localities to incorporate PCV13 into locally expanded immunization programs or people-benefiting projects. A monitoring and evaluation system should also be established to evaluate implementation effects.
摘要:
世界卫生组织(WHO)将肺炎球菌疾病列为疫苗可预防的疾病,并建议将肺炎球菌结合疫苗(PCV)纳入全球国家免疫计划。然而,PCV未纳入中国国家免疫规划,由于其成本较高,疫苗接种覆盖率较低。为了解决这个问题,潍坊市于2021年6月1日实施了13价PCV(PCV13)的创新战略。该策略旨在为注册家庭中6个月至2岁的儿童免费提供一剂PCV13,并采用商业保险模式,在2023年为2岁以上的儿童免费提供一剂PCV13。潍坊市卫生健康委员会等部门进行了全面调查,综合考虑各种因素,比如疫苗的有效性,安全,可访问性,疫苗价格,和免疫计划,适用于符合条件的儿童(5岁以下)。在实施该政策之前,还征求了利益相关者的意见。委员会与各种疫苗制造商进行了谈判,以最大程度地提高其谈判能力并降低疫苗价格。实施方案是在健康潍坊战略下出台的。在实施这一战略之后,全疗程疫苗接种覆盖率从0.67%显著上升至6.59%。然而,疫苗接种覆盖率仍然低于发达国家。潍坊市的PCV13疫苗接种创新策略在中国大陆尚属首创,是非免疫规划疫苗接种策略的积极试点。进一步推广PCV13疫苗接种,潍坊市应继续实施这一战略,探索合适的融资渠道。经济发展水平较高的地区可以创新实施疫苗计划,拓宽融资渠道,提高疫苗接种服务的可及性,并倡导更多地方将PCV13纳入当地扩大的免疫计划或惠民项目。还应建立监测和评估系统,以评估实施效果。
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