The number of vaccine doses required for children in China far exceeds the international level. Promoting the use of combination vaccines for children is an important measure to significantly reduce the number of doses and increase children’s immunization coverage, bringing multiple benefits such as 1) enhancing the timely vaccination of children and creating space in the current National Immunization Program schedule for the future introduction of new vaccines; 2) increasing vaccination compliance among young children; 3) reducing the risk of potential adverse events following vaccination; 4) lowering the time cost for caregivers; 5) reducing the occupational exposure risk for health workers; and 6) saving overall societal costs significantly. Many countries have already included pentavalent and hexavalent vaccines in their immunization plans. The combination vaccines authorized for use and in various stages of development in China exhibit a notable disparity compared to those of other countries internationally, including some leading nations. Factors restricting the application of combination vaccines for children include 1) regulatory constraints in R&D cooperation among vaccine manufacturers; 2) the manufacturers’ insufficient qualifications and capabilities for R&D; 3) conflicts with the current immunization schedule, which brings challenges to healthcare workers in managing the vaccination intervals; 4) low incentives for healthcare workers to recommend the combination vaccines; 5) high market prices of the combination vaccines and limited awareness and willingness to vaccinate among parents. It is recommended that the focus be on breaking key constraints to promote the development and application of combination vaccines for children, with the top priority being to improve regulatory measures and provide market profiles to encourage vaccine development in the private sector. This includes: refining regulatory measures for R&D collaboration among vaccine manufacturers, encouraging different types of R&D collaboration to increase the supply of combination vaccines, improving the provision of evidence, making strategic planning of the National Immunization Program to guide the combination vaccines’ schedule administration; improving the vaccine procurement and financing mechanism to enhance the affordability of the vaccines; strengthening education and incentives to raise the awareness of combination vaccines and improve the willingness of parents to vaccinate their children with the combination vaccines.
本研究为比尔及梅琳达·盖茨基金会（INV-034554）支持的“疫苗与免疫服务提供创新实验室”项目产出。本文内容完全由作者负责，不代表资助者的任何观点。
我们诚挚感谢昆山杜克大学作为项目牵头单位的鼎力支持，以及所有合作大学、政府部门和相关机构提供的技术支持。特别感谢为此简报提出宝贵意见和技术支持的各位专家，尤其是中国疾病预防控制中心免疫规划中心余文周主任医师、国务院发展研究中心社会和文化发展研究部葛延风研究员、张佳慧研究员、资深医药健康撰稿人、前南方周末资深医药记者袁端端女士、比尔及梅琳达·盖茨基金会高级项目官杜珩博士。此外，特别感谢北京大学在读研究生邓添艺在前期收集整理和制作相关证据库；特别感谢昆山杜克大学全球健康研究中心联合主任汤胜蓝教授及其团队的鼎力支持。
Juling received her bachelor’s degree in Cognitive Science from the Johns Hopkins University, an MPhil in Management from the University of Cambridge, and an MHS in Molecular Microbiology and Immunology from the Johns Hopkins Bloomberg School of Public Health. She is a member of Phi Beta Kappa—the most prestigious academic honor society in the U.S.
Rotavirus gastroenteritis (RVGE) is a global public health problem that seriously threatens the health of children under 5 years old, causing up to 200,000 mortality of children each year. In China, the burden of RVGE remains substantial and is difficult to prevent and control.
Compared to young and middle-aged adults, older adults bear a higher disease burden and lower immunity against viruses. Some epidemics are more likely to outbreak in places where the elderly gather, such as nursing homes.
Currently, most of China’s regions handle procuring and distributing its National Immunization Program (NIP) and non-NIP vaccines separately. Different entities or stakeholders undertake the distribution of NIP and non-NIP vaccines from the vaccine manufacturers to the county and district-level CDCs.
