Dr. Vu Minh Huong, Director of Vaccines and Immunization for the PATH Mekong Regional Program
Photo: PATH/Molly Mort
While on a visit to a district hospital in Hoa Binh Province, Vietnam, in the summer of 2013, I saw a newborn baby boy lying with his mother in the hospital. Although the hospital had available stocks of hepatitis B birth-dose vaccine, I learned that the doctor did not vaccinate him. This left the infant at risk of mother-to-child transmission of hepatitis B and the chronic infection and complications it can cause later in life, such as liver cancer.
The baby missed his chance for protection because of general fear, confusion, and misinformation about vaccines. That summer, a flurry of negative media attention about vaccine safety had led to steep drops in immunization coverage for hepatitis B and many other vaccines. As I witnessed in Hoa Binh Province, one of the key factors was that many physicians, nurses, and midwives working in provincial and district hospitals were unsure of their responsibility to deliver vaccines to newborns and children to protect them from hepatitis B and other childhood diseases. This resulted in outbreaks of measles and Japanese encephalitis in Vietnam.
While Vietnam had long had a robust National Expanded Program on Immunization (NEPI), the situation in 2013 was paralyzing the immunization system. It revealed opportunities for improvement in the way that the Ministry of Health (MOH) manages, distributes, and communicates about vaccines.
This was especially important to address as Vietnam will soon graduate from the support of Gavi, the Vaccine Alliance and will need to sustain vaccination services on its own. Additionally, several new lifesaving vaccines—rotavirus, pneumococcal, and HPV—have not yet been introduced into Vietnam’s routine immunization system, and vaccines remain uncovered by public health insurance, making them too expensive for many families.
The opportunity: a Decree on Immunization
Recognizing all of this, the MOH decided to develop a Decree on Immunization—a law that would reform, restructure, and strengthen the immunization system. Because of PATH’s long history of providing technical assistance and strategic support for important child health policies, the MOH called on PATH to help develop the decree. I was pleased to get this opportunity to help create a policy that can improve vaccine access and help save more children’s lives.
Over the past year, PATH’s expertise in delivery and regulation of vaccines in the Mekong region has helped inform and influence the design of a new system. With financial and technical support from PATH, the first draft of the decree was finalized in late 2014 and is now under review by the MOH and other relevant ministries. It will also be circulated to collect public opinions before final approval.
I am grateful to the MOH for acknowledging this important and lifesaving Decree on Immunization for the health of the Vietnamese people. I am confident that, once enacted, the decree will provide a framework to improve vaccination coverage and strengthen the NEPI and the broader health system.
Vaccines save lives. My dream is that, with the needed reforms in place, babies like the one I saw in Hoa Binh Province will receive the protection they need to live long and healthy lives.