Many localities lack vaccines for expanded immunization

Ho Chi Minh City and many other provinces have run out of free vaccines for children and are asking the Ministry of Health to distribute them, but according to new regulations, the provinces must take care of them themselves.

On May 16, a representative of the Ho Chi Minh City Department of Health said that vaccination facilities in the area had completely run out of DPT-VGB-HiB and DPT vaccines for free injection.

Accordingly, the DPT-VGB-HiB vaccine (5 in 1 capable of preventing diphtheria, whooping cough, tetanus, hepatitis B, Hib pneumonia and Hib meningitis) was last provided in October 2022 and has been out of stock since early March.

The DPT vaccine (to prevent 3 diseases: diphtheria, whooping cough and tetanus) was last provided in February and ran out in early May. These are vaccines provided periodically by the Expanded Immunization Program, the National Institute of Hygiene and Epidemiology, and the Ministry of Health, with the quantity based on the registration of vaccination needs of each locality.

Every month, Ho Chi Minh City needs more than 5,000-11,000 doses of each type of vaccine to vaccinate children for free. According to the representative of the Department of Health, other types of vaccines in the Expanded Immunization Program also have very limited quantities left, expected to run out in the next few months if no more are provided. Specifically, from the end of May to September, the city will run out of vaccines for hepatitis B, Japanese encephalitis, tuberculosis (BCG), polio (bOPV), measles, tetanus (VAT), measles and rubella (MR).

Vaccination for children at the hospital. Photo: Chile — Vaccination for children at the hospital. Photo: *Chile*

In Hanoi, Mr. Khong Minh Tuan, Deputy Director of the Hanoi CDC, also said that the capital is lacking vaccines for the expanded vaccination program for children. "This is a common situation in all provinces and cities, not just the capital, because up to now there has only been one source of supply from the Ministry of Health," Mr. Tuan said, but did not specify the number of vaccines in short supply.

Many other localities are facing similar situations such as Tien Giang, An Giang, Quang Ninh, Ha Giang, Binh Duong... For the past half year, Ha Giang has not had DPT-VGB-HiB vaccine to inject, and DPT vaccine has been out for 2 months.

"City residents still have money to get vaccinated, while ethnic minorities in the highlands can only wait," said the leader of CDC Ha Giang.

Why is there a lack of free vaccines?

In recent years, the Ministry of Health has purchased vaccines for the Expanded Immunization Program from the central budget allocated by the Ministry of Finance. The vaccines are then distributed to localities to organize free vaccinations for children. However, the interruption in vaccine supply has occurred since last summer. The reason is due to some procedures related to procurement regulations, including price. Vaccine manufacturers said that "vaccines are available in stock, but cannot be released for vaccination."

The shortage becomes more serious when, according to new regulations, from 2023, the Ministry of Finance will not allocate budget for the Ministry of Health to purchase, and propose to implement according to regulations on budget decentralization. That is, localities will purchase expanded vaccination vaccines themselves to serve the needs of the province or city.

In this context, localities are complaining about difficulties because they have not implemented it yet, have not found a source of supply and are also worried about the difference in purchasing prices. Many provinces and cities have proposed that the Ministry of Health should continue to purchase, and the purchase money will be paid by the localities.

However, the Ministry of Health said this was not feasible, and requested that the Departments of Health determine the needs, make a supply plan, report to the local People's Committee to arrange funds and organize purchases, and avoid shortages of drugs and vaccines.

Hanoi vaccinates children, April 2022. Photo: Pham Chieu — Hanoi vaccinates children, April 2022. Photo: *Pham Chieu*

At the meeting on May 11, the Government leader asked the Ministry of Health to resume bidding and resolve the problem of vaccine shortage. A day later, the National Institute of Hygiene and Epidemiology sent an urgent dispatch asking localities to register their vaccine needs for the expanded immunization program. "Thus, it can be understood that the bidding and procurement of vaccines is still chaired by the Ministry of Health," said a vaccination expert.

Mr. Nguyen Trong Dien, Director of the Quang Ninh Department of Health, said that the province has sent a registration of vaccine demand to the National Institute of Hygiene and Epidemiology. Accordingly, the locality has registered the number of vaccines for 2023 and plans for an additional 6 months of 2024.

"The Ministry of Health will purchase the vaccines, then the province will transfer the funds from the vaccine budget to pay," said Mr. Dien.

Leaders of the Ho Chi Minh City and Ha Giang Departments of Health also said that they have sent vaccine estimates to the Expanded Immunization Program for the remaining months of 2023 and reserves for the first 6 months of 2024 to be supplied as before.

Expanded Immunization is a national, free immunization program that protects children from a number of common and highly fatal infectious diseases such as tuberculosis, diphtheria, whooping cough, tetanus, polio, hepatitis B, measles, Japanese encephalitis, cholera, typhoid, pneumonia, and Hib meningitis.

When there is no vaccine for widespread vaccination, people seek out expensive private vaccination services. Others have to wait, risking illness due to not being vaccinated on schedule. On the other hand, when immunity from vaccines wanes, the risk of widespread disease outbreaks occurs, threatening the health system as well as people's lives.

Currently, the Ministry of Health has not responded to the vaccine shortage or the vaccine procurement plan for the upcoming expanded immunization program.

Le Nga - My Y

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