Vaccines in China: Challenges and Benefits

A two-part report on Asia’s growth forecast covers six economies from Japan to India, with some key dynamics on display. Here is an edited excerpt.

Japan is once again the latest country to amend its immunization laws so that children living in households where at least one member has HIV can have access to booster shots. This law change is not without its complications; a number of new cases of hepatitis B and diphtheria have been detected since the immunization law changed in December 2017. At the end of March 2018, almost 2,800 hepatitis B and 1,700 cases of diphtheria had been detected among children.

These cases raise doubts about the effectiveness of the new immunization law, and the potential drawbacks of expanding immunization coverage.

In another development, several states in India are testing some infants before they are formally inoculated. Doctors fear that patients could mistakenly be vaccinated against a serious disease before their parents have first considered the issue. The uncertain response to the “vax-precautions” has led to new legislation, and an Indian government inquiry. The uncertainty may stem from the fact that, while India’s public health institutions are partly funded by the state, immunization is administered directly to patients in many instances. Doctors worry that government surveillance on a large-scale would overburden these organizations, which would also end up caring for many children who were not known to have been vaccinated.

Meanwhile, governments in other parts of Asia seem to be moving forward on vaccines against common and more prevalent illnesses that do not require the same high levels of vaccination as highly contagious diseases like measles and polio. In India, a number of states have started offering tetanus toxoid (TT) boosters to children under the age of 5 months, in order to protect against the rare but serious disease. Experts predict that, in a few years, the TT boosters will become mandatory in India. This will put the vast majority of the population at much greater risk of getting tetanus infection, which can lead to severe and sometimes fatal complications. The current number of children dying from tetanus in India is thought to be a fraction of the real figure.

Also in India, universal immunization is being considered for inclusion in the country’s new healthcare reform bill, which aims to reduce child mortality by 3 million cases per year by 2020. India is Asia’s largest democracy, but only half of its children are vaccinated, according to UNICEF estimates.

Meanwhile, Malaysia has introduced a public health ministry and new vaccination regulations, which require all religious schools and preschools to accommodate injection regimens, where available. The regulation may achieve greater integration of vaccines in schools, but it will likely put an additional strain on the country’s health services.

By way of contrast, China also recently introduced changes to its immunization regulations, which mandate that members of a particular family be vaccinated. This aim is to protect against a number of diseases, including tuberculosis, hepatitis B, HIV, diphtheria, tetanus, measles, and whooping cough. This change has come at a significant cost; state-run clinics have been forced to redirect many health workers to vaccination oversight, and more than 40 percent of them are currently absent.

Yohande Nkontsemi

Senior International Affairs Journalist


East Asia Correspondent

The Economist

Senior Writer


Photo illustration by Lintao Zhang/Getty Images

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