How do other countries supervise vaccination?

Recently， the illegal vaccination operation in Ji- nan， Shandong province raises public concerns. There is no doubt that the safety of vaccine is a serious livelihood issue concerned by all countries public health industry. The quality of the vaccine determines the health of vaccinators.

Globally speaking， there was similar “poisonous vaccine” in different countries. How did these countries deal with the incident？ How did the governments work out the relief system？ Faced with terrified parents who refuse to inject any vaccine to their children， what measures did the government take？ How did government in developing countries use vaccine to raise childrens survival rate？

America： vaccine incidents push out strict supervision

The Cutter incident in 1955 was said to be the worst disaster happened in Americas history of vaccination. Food and Drug Administration （FDA） official on condition of anonymity pointed out that the vaccine supervision system in America was in chaos then.

The virus in the polio vaccine produced by Cutter medicine manufacturer was not thoroughly inactivated， which caused 40，000 infected， hundreds of children in paralysis and five died among the 120，000 children vaccinated.

However， the court decided that Cutter was free from criminal offence， but the national health research department should take the responsibility because the director William had ignored the tested monkeys negative effect of turning disabled after injected the vaccine in 1954.

America health and public health department principal and a number of other officials lost their jobs. This case pushed America to build up strict vaccination supervision system.

Former senior researcher Fan Jun said， the system was quite complete. Operation violating rules will face great loss. To speak from the perspective of business， the production of the vaccine hardly has any benefits for the manufacturer.

Americas current vaccine supervision system bears strict controlling measures in all steps including researching， producing， transporting， restoring， using and getting feedback.

As introduced by Fan Jun， any improper operation will trigger supervision mechanism of FDA. In recent years， many medicine manufacturers were closed after the investigation of FDA. Most of them were not involved in fraud， but had problems of quality management.

It is said that several branches of vaccination safety team under FDA Monitor the potential risk of listed vaccines to the public health at all times. Upon discovery of risk， the team will order the manufacturer to call back or remove the vaccine off shelves， thus， any behavior violating rules will bring great loss.endprint

Fan Jun said that FDA had great power over medicine supervision， which avoided disputes among many government agencies.

By strengthening the supervision over vaccination， the strict Vaccine Adverse Event Report System （VAERS） also helps people recognize that good sides of vaccination are far more than risk. This system plays an important role in Americas public health industry.

According to Americas National Childhood Vaccine Injury Act （NCVIA） of 1986， medical professional staff and vaccine manufacturers have the responsibility to report vaccination adverse events to health and public service department. VAERS was jointly founded by Center for Disease Control and Prevention （CDC） and FDA in 1990 to collect these reports.

So far， this system has collected over 200，000 reports， mostly of which are about slight negative effects after vaccine injection. As a national spontaneous reporting system， VAERS has played its special role in popularizing of vaccine knowledge， giving feedback to vaccine using instruction and investigation.

The vicious vaccination incidents hasten releasing of strict and complete laws and rules. America has seen many vaccination incidents apart from Cutter incident. For example， in 13 children died from infection of tetanus vaccine in St. Louis， Missouri in 1901. In the same year， nine children died from infection of smallpox vaccine in New Jersey.

These two incidents pushed America to pass the Biologics Control Act in 1902. All relevant incidents will be documented， Wreckers will be seriously punished， including getting fines and taking criminal responsibilities， or even being listed in blacklist and banned from the industry.

Australia： no vaccination no benefit

In 2006， 18，899 children under seven didnt get vaccination due to their parents ‘concerns of private， religious or medical reasons. That was about 1.03% of the total children at the same age in Australia. In 2011， the number of children without vaccination raised to 29，968 and 39，523 in 2014， nearly two times of the number in 2006. Faced with this situation， Australia government passed laws to make childrens vaccination a premise of getting benefits.

The government then announced that since Jan. 1， 2016， the policy of “no vaccination no benefit” would take effect. Parents refusing to get vaccination for their children will get no parenting benefits or welfare funded by taxpayers， including 200 Australian dollars of parenting benefits each week， 7500 Australian dollars nursery fee commission and 726 Australian dollars benefits for A-class families annually. In this way， if one family has two young children without vaccination，it will cause loss of 30，000 Australian dollars in the familys parenting benefits and welfare allowances.endprint

Former Australia Prime Minister Albert said， unless with persistently effective exemption from medical care or religious background， all families would get no benefits if they refuse to get vaccination for their children. The “no vaccination no benefit” policy is a public health measure with significant importance to the protection of children and family safety.

Meanwhile， the vaccine injection rate stalls around 92% in Victoria State， southeast of Australia. The Victoria state government has carried out the new policy of “no vaccination no game” since Jan. 1， 2016， which means that children before school age without vaccination will not be allowed in the child care center or kindergarten.

Health department director said the government shall be tough in vaccination issue to save life. The pertussis cases raised 1000 in 2015 compared with 2014. The policy is not just for a single childs benefit， but for everyones safety in the community.

Italy： stress doctors responsibility of raising vaccination rate

Currently， Italys children measles vaccination rate is below 86%. In order to raise vaccination rate， the government released the Plan of National Vaccination from 2016 to 2018 at the end of 2015. Italy health minister Lorenzin stated that the new plan was crucial to public health and national security.

The plan required doctors working within the public health system to support the expansion of this new vaccine. Doctors who refused to cooperate will face punishment. As the director of Anaao Assomed （a public health system with 22，000 doctors）， Troise said the new plan was shocking， so complex a work as the expansion of vaccination， it was improper to threaten doctors to take the burden.

This plan arouses protests from doctors and public health department. They worried that behind the plan were medicine enterprises. The plan only includes a series of vaccine lists， but without any national strategy.

Germany： call back infected vaccine

In October， 2012， white particle was found in some injection of flu vaccine produced by Novartis， the medicine producing giant of Switzerland. Germany vaccine approval authorities immediately investigate flu vaccine circulated in the market. Although no white particle was found， the relevant authorities called back the batch of vaccine to protect patients， and prevent any allergic effects or other negative effects.endprint

According to the weekly report by Germany Der Spiegel，the authorities released 14.2 million free vaccines of all kinds in 2012， and the called back vaccine in October was about 100，000.

England： the minister of health is the only legal vaccine seller

To ensure the safety and stability of the vaccine， England strictly control certificate of vaccine manufacturer. The manufacturers researching ability， production equipment and capital shall all go through strict assessment of England minister of health. At the same time， the minister of health is the only legal seller of vaccine in England. Its purchasing power of vaccine is in monopoly. Thus， the minister of health leads the cooperation with manufacturer. The contract price agreed by two parties is lower than market price.

Many enterprises step back slim profits of vaccine production， which leads to declining vaccine manufacturers. The varieties of vaccine on the other hand grow.

Japan： the government compensates victims of vaccination

Japan government made relief system of prevention vaccine victims in 1977. The national responsibilities in the Law of Prevention Vaccination were modified twice in 1994 and 1999. According to the rules， the government acts at the principle of consequence liability. Victims with harms confirmed by the health minister as the result of prevention vaccine will all be compensated， including medical fee， hospitalization allowance， handicapped children patenting benefits or subsidy of the handicapped， one-time death subsidy and funeral expenses. These acts are in the aim to ease the publics worries over the negative effects of vaccine. The government will compensate victims 4.21 million yen together with funeral expenses if the vaccination causes death.

Rwanda： ten kinds of vaccines are included in the regular immunization plan

In 2009， under the support of the International Vaccine Action and partners， Rwanda became one of the first countries in the Sub Saharan Africa to introduce pneumococcus vaccine. At the same time， Rwanda also built up primary medical system. The government has included ten kinds of vaccines in the regular immunization service， including new rotavirus vaccine preventing diarrhea. One fifth of children death rate in Rwanda is caused by diarrhea.

Noala Skinner， representative of United Nations Childrens Fund in Rwanda， thinks that the introduction of new type of vaccine is crucial. To strengthen overall medical system， carry out close cooperation through the communitys medical center， village committee and local hospitals have great effects on the raising on childrens survival rate.endprint

Argentina： vaccine test violating rules face serious fines

In 2007 and 2008 an international medicine company in provinces of San Diego， Mendoza and San Juan in Argentina did pneumonia vaccine tests on 14，000 children from poor families. Nine tested children died soon after getting injection.

After the incident was released by the media， Argentinas National Medicine， Food and Medical Technology Administration immediately started investigation. Although there was no evidence the childrens death was directly related to the vaccine injection， the medicine manufacturer was found operating vaccine tests violating rules.

The doctors from the medicine manufacturer didnt explain the details of the potential negative effects after the injection of vaccine， thus， the parents were not able to make overall assessment of the potential risk of vaccination. Children of some parents who signed the agreement were not old enough to take vaccine injection. Some parents who signed the agreement were illiterate. In addition， one agreement was signed by a mother mental disease.

Argentinas National Medicine， Food and Medical Technology Administration imposed a fine of 400，000 peso on the company， 300，000 peso on each doctor participated the vaccine test.

The medicine manufacturer made an appeal to Argentinas economic court. The vaccines were allegedly approved by 85 countries and regions including the European Union， thus， there was no problem with the medicines safety. However， the judge rejected the appeal， affirming that the companys operation during the vaccine tests violated rules.endprint