China struggles with vaccine shortage after safety scandal

BEIJING — Chinese parents are being refused vaccines for their children as shortages force doctors to ration supplies amid government attempts to cut out private middlemen after a vaccine safety scandal this year.

Parents have resorted to travelling from clinic to clinic in search of vaccines, with some turned away until September when a new distribution system is expected to come online.

“I was angry but couldn’t do anything other than wait,” said Mr Tang Zhiming, who was turned away from several clinics in the southern city of Guangzhou when he tried to get shots for his three-year-old.

The supply shortage is “temporary” and caused by “work integration issues”, the China Food and Drug Administration said this month, adding that “national production can meet market demand”.

Distribution is now among the main challenges for the vaccine programme, after the abrupt removal of middlemen. This month, Beijing kicked off tenders that normally take place in the winter but were delayed by the uncertainties of the new system.

In March, Chinese media revealed that the police in eastern Shandong province had last year cracked a ring of private wholesalers who had sold US$88 million (S$120 million) in expired or spoiled vaccines to local centres for disease control throughout China.

In response, Beijing mandated producers to sell directly to CDCs, which are local clinics run by China’s Centre for Disease Control and Prevention. But delays and uncertainties in implementing the new system have caused supply to local clinics to dry up.

The shortages have mostly hit Class II”vaccines which — unlike state-mandated Class I vaccines — are optional and paid out of pocket and are a main source of revenue for the CDCs.

The policy scrapping “flexible” vaccine sales and distribution channels in favour of new CDC procurement platforms was “a little bit too hasty”, said Shanghai-based vaccine expert Tao Lina. “This type of transition should not happen overnight, it should be a long process.”

The crackdown on the Shandong-based ring was kept quiet for almost a year for fear it would erode confidence in Chinese vaccines among the Chinese public and foreign export markets.

Pharmaceutical industry officials told the Financial Times this month they had been aware of the scandal before Chinese media reported it. Nonetheless, the health authorities attempted to trace potential victims only after the reports.

High levels of vaccination in Chinese children will probably protect against serious disease outbreaks while the government sorts out the new distribution system, said Dr Lawrence Rodewald, the World Health Organisation’s vaccine specialist in Beijing.

Vaccine producers and public health officials complain of red tape and marketing networks that are not set up to cope with 2,900 county-level CDCs. “Gaps” have appeared in the supply chain — in which vaccines must be kept in a narrow temperature range — when producers have to ship directly to small CDCs. The new policy requires vaccine tenders to be conducted via provincial procurement platforms, which exist in only a few provinces.

“Provincial CDCs told us that they don’t have the procurement platforms in place, they haven’t updated their systems and, most importantly, they haven’t fully digested or understood the new policy,” said Ms Ding, an executive at a vaccine producer in south-west China, who asked to be identified only by her surname. “They couldn’t start the tender process and as a result we couldn’t sell vaccines to them.”

Contributing to the shortage is the removal of Class II vaccines as a source of revenue for the CDCs, making them less willing to hold stocks. The drop in orders caused some producers to cut output, according to people in the industry. FINANCIAL TIMES