Vietnam can't afford to switch to newer, safer vaccines: official

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Vietnam will switch to modern, safer vaccines, when it can afford to, but those being used are safe enough, a vaccine official said in a recent interview.

Dr. Nguyen Tran Hien, chief manager of the National Extended Vaccination Program, told Thanh Nien in an interview published Monday that the vaccines currently used in Vietnam have significantly reduced the number of infections nationwide, and there's no evidence they are responsible for recent deaths.

"Replacing old-fashioned vaccines with new ones is recommended, but it depends on each country's financial capacity.

"Any vaccine, old or new, must be stored and administered safely; and all vaccines being used in Vietnam meet all safety standards."

Hien's statements were meant to quell concerns raised at a Hanoi conference on July 24, just days after four newborns died after receiving Hepatitis B (HepB) vaccinations.

The doctor and nurse who administered the HepB shots to the three babies that died at Huong Hoa District Hospital in the central province of Quang Tri on July 20 have been suspended pending an investigation. The other baby was from the nearby Binh Thuan Province.

Meanwhile, on July 31, deputy Prime Minister Nguyen Thien Nhan approved the health ministry's request that the country end its Quinvaxem moratorium.

Vietnam's Health Ministry suspended its use early in May for testing after nine babies died starting last November following shots of the pentavalent vaccine. But by mid-June, the WHO had reported that its tests found no problems with the vaccine and that it should be used.

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The liquid drug, pre-qualified by WHO, has been distributed in Vietnam for free since June 2010, and is given to babies from two months old to immunize them against diphtheria, tetanus, whooping cough, hepatitis B, and Hib (Haemophilus influenza type b).

Some parents have been paying VND500,000 (US$24) per shot for their children to receive Pentaxim, an acellular five-in-one shot produced by French company Sanofi Pasteur with purified antigens that are supposed to be safer than the whole-cell preparations found in the whooping cough component of Quinvaxem.

Hien said both vaccines are safe and there is no evidence showing that Quinvaxem led to the series of deaths.

Vietnam is also using an old version of Japanese encephalitis vaccine (JE-Vax) that uses brain cultures from mice, while the modern version (Ixiaro) uses vero (monkey kidney) cell cultures.

JE-Vax is produced by Vabiotech under the health ministry with technology delivered from Osaka University, and has been administered in Vietnam since 1997.

Hien said it has reduced cases of brain inflammation caused by the Japanese encephalitis virus from 61 percent in 1991 to 9.9 percent in 2012.

"The vaccine is safe, only causing brief effects like red swelling at the injection spot, fever and headache."

He said severe side effects like encephalomyelitis inflammation of the brain and spinal cord only occur at a rate of one per one million shots administered, and that no such case has been recorded in Vietnam.

The WHO in 2012 still listed JE-Vax as one of the options for the encephalitis virus, he said. It now costs around VND30,000 per shot for children in Vietnam, and a bit more for adults.

He said the ministry's vaccine company is going to test the new vero-based vaccine on people soon, using funds from the Ministry of Science and Technology.

Experts at the July 24 conference said the Vietnamese government needs to spend more money to make sure the children are given the modern, safer vaccines.

Do Sy Hien, former manager of the vaccination program, was quoted by news website VnExpress as saying that the safety gap between older and newer vaccines is "very wide."

"For example, the whole-cell whooping cough vaccine exposes children to 3,000 antigens while the new purified vaccine only has three to five antigens, and that will reduce many effects."

He also said that after ten years, Vietnam is still using oral polio vaccines, as it has no money to distribute the shots now used in many countries. The oral variety carries the risk of the virus being released into the environment. 

Officials said recent inspections at nearly 100 Hanoi locations where vaccinations are administered detected various misconduct concerning injection techniques, the preservation of the vaccines and consultation over possible side effects. 

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