Influenza Deaths and Vaccinations Data 2015-2020

Paul Jackson made this Freedom of Information request to Department of Health

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Dear Sir or Madam,

Please can you provide the following information.

1. How many Hong Kong SAR deaths were attributed to influenza in each of the years 2015 to 2020?

2. How many Hong Kong SAR residents were counted as fully vaccinated for influenza for each of the years 2015 to 2020?

3. What was the estimated number needed to vaccinate against influenza to prevent one death from influenza, in each of the years 2015 to 2020?

4. Please clarify if the numbers provided for 3. were estimated before or after the annual public influenza vaccinations commenced.

5. If multiple estimates were made for each year, please provide a summary – for example quarterly estimates over each year.

6. Please provide breakdowns by age for each of 1., 2., 3. and if applicable, 5.

Thank you in advance for your assistance in this matter.

Yours faithfully

Paul Jackson.

Department of Health

Dear Paul Jackson,

Our department received your application for access to information on
10.7.2021.

Your application is now under processing.  According to paragraph 1.16 of
the Code on Access to Information, we will inform you of the latest
progress of the case on or before 30.7.2021.

If you have any enquiries, please contact me at 3107 2575.  Thank you.

Regards,
Francis CHING
for Director of Health

show quoted sections

Department of Health

Dear Paul,

Thank you for your email of 10 July 2021 seeking access to information
relating to influenza deaths and vaccination data from 2015-2020.  

For Q1, seasonal influenza is not a statutory notifiable disease in Hong
Kong. The Centre for Health Protection (CHP) of the Department of Health
(DH) does not have the information on the number of people diagnosed with
influenza locally. For the local situation of seasonal influenza in
previous years, information is accessible at the CHP website:
(i) the weekly publication of Flu Express at
[1]https://www.chp.gov.hk/en/resources/29/3... and
(ii) the biweekly publication of Communicable Disease Watch at
[2]https://www.chp.gov.hk/en/resources/29/1....

For Q2, DH has been administering the following vaccination programmes
/schemes to provide free /subsidised seasonal influenza vaccination (SIV)
to eligible persons –
(i) Government Vaccination Programme (GVP), which provides free SIV to
eligible children, elderly and other target groups at public clinics and
residential care homes;
(ii) Vaccination Subsidy Scheme (VSS), which provides subsidised SIV to
eligible children, elderly, persons aged 50 to 64 years and other target
groups through the participation of private doctors; and
(iii) Seasonal Influenza Vaccination School Outreach (Free of Charge)
Programme (SIVSOP), which provides free SIV to eligible schoolchildren
through school outreach.

The number of recipients of specific target groups under the Government’s
vaccination programmes/schemes from 2015 to 2021 are as follows -

+----------------------------------------------------------------------------+
| |2015/16|2016/17|2017/18| 2018/19 | 2019/20 | 2020/21 |
| | | | | | |(as at 27 |
| | | | | | |June 2021)|
|---------------------+-------+-------+-------+---------+---------+----------|
|Children of age 6 |47,600 |60,200 |80,700 | 106,900 |147,200~ | 115,100~ |
|months to under 6 | | | | | | |
|years | | | | | | |
|---------------------+-------+-------+-------+---------+---------+----------|
|Children of age 6 to | - |52,000 |70,700 |201,300~ |253,500~ | 220,300~ |
|under 12 years ^ | | | | | | |
|---------------------+-------+-------+-------+---------+---------+----------|
|Persons of age 50 to | 6,700 | 6,700 | 7,400 | 156,800 | 194,500 | 222,000 |
|64 years # | | | | | | |
|---------------------+-------+-------+-------+---------+---------+----------|
|Persons of age 65 |457,800|478,000|531,400| 555,000 | 610,600 | 614,700 |
|years or above | | | | | | |
|---------------------+-------+-------+-------+---------+---------+----------|
|Others * |64,300 |79,900 |91,700 | 102,200 | 112,700 | 122,000 |
|---------------------+-------+-------+-------+---------+---------+----------|
| Total|576,400|676,800|781,900|1,122,200|1,318,500|1,294,100 |
+----------------------------------------------------------------------------+

~The Pilot Programme was launched in October 2018 to provide free SIV to
eligible primary students. Given the effectiveness of the Pilot Programme,
the DH has regularised the programme in October 2019 to SIVSOP to cover
more primary schools, and expanded  to reach out to kindergartens and
child care centres (KGs/CCCs) on a pilot basis.  The DH has regularised
the programme to KGs/CCCs in 2020/21 vaccination season.

^ Starting from 2016/17, the GVP has been expanded to cover children aged
6 to under 12 from families receiving Comprehensive Social Security
Assistance (CSSA) or holding valid Certificates for Waiver of Medical
Charges while VSS has been further expanded to cover children aged 6 to
under 12.

# Starting from 2016/17, GVP has been expanded to cover people aged
between 50 and 64 receiving CSSA or holding valid Certificate for Wavier
of Medical Charges were eligible for receiving SIV, while starting from
2018/19, the VSS has been expanded to cover all persons aged between 50
and 64.

* Eligible pregnant women, persons with chronic medical problems,
healthcare workers, poultry workers, pig farmers or pig-slaughtering
industry personnel, etc.

As some target groups members may have received SIV outside the
Government’s vaccination programmes / schemes, they are not included in
the above statistics.

For the latest statistics on Government’s vaccination programmes /
schemes, please visit the CHP website at
https://www.chp.gov.hk/en/features/10222....

For Q3 to Q6 (except the breakdown by age group for Q2, which is provided
in our reply to Q2 above), we do not have such figures or information.  

If we can be of any assistance in the provision of other information in
the future, please do not hesitate to contact us again.

(Oma YU)
for Director of Health

From:        Francis YM CHING/DH/HKSARG
To:        [FOI #698 email]
Cc:        [Department of Health request email]
Date:        19/07/2021 16:43
Subject:        *Restricted: Freedom of Information request - Influenza
Deaths and Vaccinations Data 2015-2020

show quoted sections

Dear Sir or Madam,

Please can you provide the following information.

1. How many Hong Kong SAR deaths were attributed to influenza in each of
the years 2015 to 2020?

2. How many Hong Kong SAR residents were counted as fully vaccinated for
influenza for each of the years 2015 to 2020?

3. What was the estimated number needed to vaccinate against influenza to
prevent one death from influenza, in each of the years 2015 to 2020?

4. Please clarify if the numbers provided for 3. were estimated before or
after the annual public influenza vaccinations commenced.

5. If multiple estimates were made for each year, please provide a summary
– for example quarterly estimates over each year.

6. Please provide breakdowns by age for each of 1., 2., 3. and if
applicable, 5.

Thank you in advance for your assistance in this matter.

Yours faithfully

Paul Jackson.

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References

Visible links
1. https://www.chp.gov.hk/en/resources/29/3...
2. https://www.chp.gov.hk/en/resources/29/1...
3. https://accessinfo.hk/en/change_request/...
4. https://accessinfo.hk/en/help/officers

Dear Oma, Francis,

Thank you for your reply.

It has taken me some time to study the information via the links you provided.

I found the following information on deaths attributed to influenza in each of the winter influenza seasons only, searching CHP's own releases plus info.gov.hk and The Standard:

2015: 502 deaths total
2016: 214 deaths total
2017: 41 adult and one child deaths
2018: 382 adult and two child deaths
2019: 356 adult and one child deaths
2020: 113 adult and no child deaths
2021: one adult and no child deaths to 22 March 2021

The average annual winter season influenza deaths over the first five "pre-COVID-19" years was thus a fraction under 300, and that obviously does not include influenza deaths outside the main peak season.

In your response, you stated that DH does not have the answer to my original Q1, but I was able to find it from other HKSARG sources including CHP itself.

Furthermore, while you provided the requested statistics for Q2, with an age breakdown as requested in Q6, but did not explain how you measured, quantified or estimated the benefit of the influenza vaccinations.

I had requested a key metric by which one could evaluate the benefit of influenza vaccinations.

From the figures you provided, it seems that there were particularly large increases in influenza vaccinations of 50-64 year olds due to the extension of the GVP, and of eligible primary students due to the Pilot Programme, comparing 2018 and 2019 with 2016 and 2015.

But where are the benefits seen in the overall influenza deaths data?

You state that "Given the effectiveness of the Pilot Programme, ..." for children and explain its extension to more primary schools, kindergartens and childcare centres.

Please can you explain how you measured the effectiveness of the Pilot Programme for children. It is clear that the huge increase in government vaccination of children has made little or no difference to influenza deaths among children, which are thankfully extremely rare. Has it made a significant difference to critical cases of influenza among children? Or school days lost?

Similarly, for the large increase in influenza vaccinations of the 50-64 year olds. Since I do not have the age stratified deaths due to influenza, it is impossible for me to observe anything in particular relating to adults of that age range. Again, the overall influenza vaccinations have certainly increased dramatically, but, up to 2019, there does not appear to have been any obvious benefit in reduced mortality due to influenza.

Please can you explain how you quantitatively evaluate the effectiveness of influenza vaccines.

Yours sincerely,

Paul Jackson

Department of Health

Dear Paul,

Thank you for your email of 5 August 2021 seeking access to information
relating to influenza deaths and vaccination data from 2015-2020.  

Seasonal influenza is a common respiratory infectious disease in Hong
Kong, which occurs throughout the year, especially during the influenza
season. For healthy individuals, seasonal influenza is usually
self-limiting with recovery in days, without the need of laboratory
confirmation.  Also, seasonal influenza is not a statutory notifiable
disease in Hong Kong.  The Centre for Health Protection (CHP) of the
Department of Health does not have the information on the number of people
diagnosed with influenza locally.

The CHP monitors the seasonal influenza activity in the community through
various surveillance systems, such as severe influenza cases in intensive
care unit (ICU) admissions and/or deaths with laboratory confirmation
among adult patients.  These cases refer to laboratory-confirmed influenza
patients who required ICU admission or died within the same admission.
 The causes for ICU admission or death may be due to other acute medical
conditions or underlying diseases.  In addition, cases not admitted to
hospitals/ICUs and/or do not have laboratory tests performed (etc.) are
not included in the surveillance data.  
According to the recommendation of the Scientific Committee on Vaccine
Preventable Diseases (SCVPD), children aged 6 months to 11 years is one of
the priority groups to receive seasonal influenza vaccination (SIV). The
SCVPD commented that “seasonal influenza vaccination is recommended for
children aged 6 months to 11 years for reducing influenza related
complications such as excess hospitalisations or deaths. Studies in
overseas have shown that vaccinating young school children may potentially
 reduce  school  absenteeism  and  influenza  transmission  in the
community.” For details, please refer to the following link:
[1]https://www.chp.gov.hk/files/pdf/scvpd_r....
The DH therefore launched the School Outreach Vaccination Pilot Programme
(Pilot Programme) in October 2018 to provide free SIV to eligible primary
school students, so as to increase their SIV coverage. The SIV coverage
for children between 6 years to less than 12 years increases from 20.5% in
2017/18 to 55.4% in 2018/19.

If we can be of any assistance in the provision of other information in
the future, please do not hesitate to contact us again.

(LUK Kar-yiu)
for Director of Health

From:        Paul Jackson <[FOI #698 email]>
To:        FOI requests at Department of Health <[Department of Health request email]>
Date:        05/08/2021 14:06
Subject:        Re: *Restricted: Freedom of Information request -
Influenza Deaths and Vaccinations Data 2015-2020

--------------------------------------------------------------------------

Dear Oma, Francis,

Thank you for your reply.

It has taken me some time to study the information via the links you
provided.
I found the following information on deaths attributed to influenza in
each of the winter influenza seasons only, searching CHP's own releases
plus info.gov.hk and The Standard:

2015: 502 deaths total
2016: 214 deaths total
2017:    41 adult and one child deaths
2018: 382 adult and two child deaths
2019: 356 adult and one child deaths
2020: 113 adult and no child deaths
2021: one adult and no child deaths to 22 March 2021

The average annual winter season influenza deaths over the first five
"pre-COVID-19" years was thus a fraction under 300, and that obviously
does not include influenza deaths outside the main peak season.

In your response, you stated that DH does not have the answer to my
original Q1, but I was able to find it from other HKSARG sources including
CHP itself.

Furthermore, while you provided the requested statistics for Q2, with an
age breakdown as requested in Q6, but did not explain how you measured,
quantified or estimated the benefit of the influenza vaccinations.

I had requested a key metric by which one could evaluate the benefit of
influenza vaccinations.

From the figures you provided, it seems that there were particularly large
increases in influenza vaccinations of 50-64 year olds due to the
extension of the GVP, and of eligible primary students due to the Pilot
Programme, comparing 2018 and 2019 with 2016 and 2015.

But where are the benefits seen in the overall influenza deaths data?

You state that "Given the effectiveness of the Pilot Programme, ..." for
children and explain its extension to more primary schools, kindergartens
and childcare centres.

Please can you explain how you measured the effectiveness of the Pilot
Programme for children. It is clear that the huge increase in government
vaccination of children has made little or no difference to influenza
deaths among children, which are thankfully extremely rare. Has it made a
significant difference to critical cases of influenza among children? Or
school days lost?

Similarly, for the large increase in influenza vaccinations of the 50-64
year olds. Since I do not have the age stratified deaths due to influenza,
it is impossible for me to observe anything in particular relating to
adults of that age range. Again, the overall influenza vaccinations have
certainly increased dramatically, but, up to 2019, there does not appear
to have been any obvious benefit in reduced mortality due to influenza.

Please can you explain how you quantitatively evaluate the effectiveness
of influenza vaccines.

Yours sincerely,

Paul Jackson

References

Visible links
1. https://www.chp.gov.hk/files/pdf/scvpd_r...