Expand the national immunization program to achieve a higher level of national health
Cctv newsWith the sound of crying, a baby born less than 24 hours will be vaccinated with his or her first vaccine — — Hepatitis B vaccine. Vaccination is a common memory of 1.3 billion Chinese, and every China citizen has enjoyed the National Immunization Program for free since the day of birth.
2018 is the 40th year for China to implement the immunization planning policy. Since the implementation of the planned immunization policy in 1978, relevant policy documents have been issued continuously, the investment of central government funds has been continuously increased, the service system has been gradually improved, and remarkable achievements have been made in immunization planning. The national immunization program has expanded from 4 to 14 vaccines, and the number of preventable infectious diseases has expanded from 6 to 15. At present, a four-level immunization program monitoring and management system covering the country, province, city and county and a three-level vaccination service network covering the county, township and village have been established, and the incidence of infectious diseases has been effectively controlled. Among them, smallpox was "eliminated" in China in 1961; After 1994, there were no new cases of polio. In 2014, the carrier rate of hepatitis B surface antigen among children under 5 years old in China dropped to 0.32%; In 2017, the incidence of measles decreased to 4.3/1 million … …
The report of the 19th National Congress of the Communist Party of China proposes to implement the strategy of healthy China, improve the national health policy, and provide all-round and full-cycle health services for the people. General Secretary of the Supreme Leader stressed at the National Health and Wellness Conference that it is necessary to unswervingly implement the policy of putting prevention first and adhere to the combination of prevention and control, joint prevention and control, and group prevention and control. Focusing on immunization planning is to provide people with the first disease prevention barrier and the most systematic health protection in the life cycle.
Vaccination has lasted for more than forty years.
Since the birth of mankind, it has always been in the struggle against infectious diseases. In this battle, human beings suffered heavy losses. In history, there have been many records that entire villages, towns and even the whole country ceased to exist because of the ravages of infectious diseases.
During the reign of Emperor Zhenzong of Song Dynasty in China, human vaccinia was invented to prevent smallpox. During the Qin Long period of the Ming Dynasty, acne pulp was used — — The focus of smallpox patients is made into vaccine and sprayed into the nose to prevent smallpox. Chinese invented human pox vaccination, though primitive, but it became the first time that human beings invented vaccine to prevent and treat infectious diseases. This method of "starting from Jiangyou, reaching Yanqi, and traveling all over the north and south" was later spread to Europe. Two hundred years after Chinese invented vaccinia, the British invented vaccinia at the end of 18th century. In June 1961, the last case of smallpox infection in China was discharged from hospital, which was nearly 20 years earlier than the last case of smallpox in Somalia on October 26, 1977.
The achievement shows the remarkable effect of different immunization strategies for different diseases. In 1950, the Chinese government put forward "autumn vaccination campaign". "Vaccination" refers to vaccination and door-to-door "sweeping" immunization in the early stage. At that time, the identification method was very simple, that is, to see if there were any spots on the outside of the upper arm after smallpox vaccination, and if not, to "vaccinate". TongFu.kabu, an academician of China Academy of Engineering and former director of Beijing Institute of Biological Products, said that after three years of implementation of autumn vaccination strategy, the number of reported cases of smallpox dropped from nearly 70,000 in 1950 to more than 400 in 1954. After that, through regular routine immunization and missed inoculation, there were no more cases of smallpox in China after 1962.
Planned immunization forms a complete cold chain system and a preliminary immune barrier.
From 1978 to 2000, this period is called "planned immunization" stage. At this stage, a complete cold chain system has been established, and the goal of 85% planned immunization coverage rate in provinces, counties and townships has been achieved successively, and the immune barrier of children’s planned immunization-related diseases has been initially established, and the planned immunization against diseases has been gradually effectively controlled.
Establishing a complete vaccine cold chain system is the key to ensure vaccine quality. The vaccine contains artificially treated pathogens or pathogenic components, which not only retains its characteristics (antigenicity) that can be recognized by the immune system, but also makes it lose its pathogenicity. As a biological product, vaccine is sensitive to temperature, and it has to go through many links such as storage and transportation from production to inoculation. In order to ensure the quality of vaccine, vaccine should be stored and transported within the standard temperature range.
The landmark achievement of this stage is that China has achieved the goal of no polio. Wang Huaqing, chief expert of immunization program of China Center for Disease Control and Prevention, introduced that in order to quickly establish an immune barrier among children and realize polio-free status as soon as possible, China has set up national intensive immunization days since December 1993, namely December 5 -6 and January 5 -6. During the National Intensive Immunization Day, two doses of polio vaccine were given to children aged 0-3 nationwide. Up to 2000, seven times and 14 rounds of intensive immunization activities were carried out nationwide, and the cumulative number of children vaccinated reached 800 million. The coverage rate of supplementary immunization report remained above 95%. After 1994, there were no more polio cases in China through immunization strategies such as routine immunization, supplementary immunization and emergency immunization, and the establishment of sensitive acute flaccid paralysis monitoring system.
Immunization program further builds immune barrier.
"What is the purpose of our vaccination? It is to control the disease. Since the 18 th National Congress of the Communist Party of China, the incidence of major infectious diseases has dropped to the lowest level in history. " Wang Huaqing told reporters about his achievements, but there was no joy on his face. In his view, every day starts from scratch and we can’t relax for a moment.
Compared with the planned immunization stage, the planned immunization stage has realized the rule of law management on the basis of scientificity and standardization. Vaccine varieties are adjusted and updated in a timely manner. In 2007, there were 14 kinds of vaccines in the national immunization program. In 2016, the polio vaccine was adjusted, with bivalent live attenuated vaccine replacing trivalent live attenuated vaccine, and inactivated vaccine replacing live attenuated vaccine in the first dose of polio vaccine. At this stage, the vaccination rate reached the goal of 90% by taking the township as the unit. Among them, the incidence of preventable diseases among children in China has dropped significantly, and the carrier rate of hepatitis B virus surface antigen among children under 5 years old has dropped from 9.67% in 1992 to 0.32% in 2014, with a drop of 97%. In 2017, the incidence of measles decreased to 4.3/1 million, and the incidence rate decreased to the lowest level in history.
At the same time of timely adjustment and updating of vaccine varieties, China began to establish a monitoring system for vaccine adverse reactions in 2005. At present, the sensitivity and quality of vaccine adverse reaction monitoring have been recognized by WHO. The establishment and application of the vaccine adverse reaction system enabled China to pass the WHO evaluation of the vaccine supervision system twice with excellent results in 2011 and 2014, which eliminated the bottleneck of domestic vaccines going global and laid the foundation for China’s vaccines going abroad. It is worth mentioning that four vaccines produced in China, such as inactivated Japanese encephalitis vaccine, influenza split vaccine, bivalent polio vaccine and inactivated hepatitis A vaccine, have passed WHO pre-certification, which means that the safety and effectiveness of the vaccines have been recognized by WHO, and the four vaccines will enter the procurement list of United Nations agencies and can be used for the prevention and control of infectious diseases in developing countries.
Achievements are hard-won, and the road ahead is inspiring. In 2017, the "Outline of Healthy China 2030 Plan" issued by the CPC Central Committee and the the State Council guided the work of immunization planning, which mentioned that it is necessary to "provide fair, accessible and systematic health services based on the whole population and the whole life cycle to achieve a higher level of national health." Wang Huaqing pointed out that from a technical point of view, the expanded immunization program needs to consider disease factors, vaccine factors and capacity factors, and a series of preparatory work should be done. This is a scientific systematic project, which needs systematic evidence and comprehensive consideration and demonstration.
Co-construction and sharing is the basic way to build a healthy China. At present, people’s confidence in vaccination has been continuously improved, and their sense of active participation in vaccination has also been continuously enhanced, and the concept of immunization planning has been deeply rooted in people’s hearts. As the most economical and effective means to prevent and control infectious diseases, "immunization program" needs to continue to coordinate the three levels of society, industry and individuals, form a strong joint force to maintain and promote health, do a good job in routine vaccination of children, emergency vaccination, missed vaccination and vaccination of high-risk groups, establish a prevention and control network to control infectious diseases, and play its due obligations and responsibilities to protect people’s health! (Text/Zhang Ke correspondent/Zhou Ying)
Thanks to the strong support of the National Center for Disease Control and Prevention for this article. )