Promoting higher-valent pediatric combination vaccines in China: challenges and recommendations for action

Abstract

Many countries have adopted higher-valent pediatric combination vaccines to simplify vaccination schedules and minimize health expenditures and social costs. However, China is conservative in the use of pediatric combination vaccines. By reviewing and synthesizing quantitative and qualitative data, in this commentary we identify gaps and challenges to combination vaccine use and make recommendations for promoting use of higher-valent pediatric combination vaccines in China. Challenges are in four dimensions: (1) legislation and regulation, (2) immunization schedule design, (3) vaccine awareness and price, and (4) research and development capacity. To optimize the use of combination vaccines to reduce vaccine-preventable disease burden, we make recommendations that address key challenges: (1) develop policies and regulations to strengthen enforcement of the Vaccine Administration Law and remove regulatory hurdles that hinder combination vaccine research and development, (2) establish an evidence-informed policy-making mechanism for combination vaccines, (3) resolve immunization schedule conflicts between monovalent and combination vaccines, and (4) implement effective interventions to increase vaccine awareness and reduce price. Graphical Abstract

Acceptance and willingness to pay for DTaP-HBV-IPV-Hib hexavalent vaccine among parents: A cross-sectional survey in China

“… 29 , 31 , 32 To our knowledge, this is the first time that parental WTP for hexavalent vaccine has been investigated in China’s mainland. However, few studies 33 , 34 have investigated the vaccination intention and WTP for combination vaccines. Similar to previous studies, 35 our results suggest that urban vs rural residence, education level, and disease knowledge are key factors influencing parents’ choice.…”

Coverage of the Combined DTaP-IPV/Hib Vaccine Among Children Aged 2–18 Months — 9 PLADs, China, 2019–2021

“…Furthermore, the preference for pentavalent vaccines among parents has been on an upward trend, despite a recent downturn in birth numbers. As the demand for combination vaccines may persistently rise, fostering research and innovation in their development within China is crucial ( 12 ).…”

“…In every province, we noted consistently higher vaccine coverage among urban children compared to their rural counterparts, although the disparities have been progressively diminishing over time. A multitude of factors influenced parental preference for non-NIP vaccines, with vaccine cost and family income proving being major determinants of acceptance (11). Given the high cost of the pentavalent vaccine in China -a four-dose series being priced at 2,488 Chinese Yuan in Hainan, families in less developed, remote, and rural areas may encounter notable limitations (5).…”

Advancing the National Immunization Program in an era of achieving universal vaccine coverage in China and beyond

“…Prof. Fanghui Zhao and colleagues discuss the advances and challenges in China’s approach to HPV vaccination as a measure against cervical cancer, acknowledging significant progress but also calling attention to the need for stable vaccine supply, fair pricing, and a focus on marginalized populations to ensure equitable vaccine access [ 8 ]. A collaborative analysis by Prof. Shenglan Tang’s Duke Kunshan University team and Prof. Fuqiang Cui’s Peking University team examines the sluggish uptake of higher-valent paediatric combination vaccines in China, citing legislative and public awareness barriers while recommending a comprehensive promotion strategy that includes stricter vaccination law enforcement, schedule alignment, and enhanced vaccine research and development [ 9 ]. Together, these commentaries underscore the necessity of a concerted effort to enhance vaccine financing, services, access, and regulatory environment to stimulate vaccine innovation, so as to improve vaccine coverage in China.…”