An analysis of Taiwan’s vaccination services in public health centers and contracted medical institutions and applications for vaccine injury compensations
Yu-Chen Hsu1, Hsun-Yin Huang1, Yu-ling Chen1, Shin-Yi Wang2, Shu-Fang Chen3, Shih-Yan Yang4
2014 Vol.30 NO.11
Correspondence Author： Yu-Chen Hsu
Vaccination is the most cost-effective weapon against vaccine-preventable diseases. Taiwan's earliest implementation of vaccination was vaccinia against smallpox. In 1948, diphtheria toxoid was introduced in Taiwan. Since then, DTP (diphtheria, tetanus, and pertussis) combination vaccines, BCG (Bacille Calmette-Guérin vaccine), OPV (oral polio vaccine), Japanese encephalitis vaccine, MMR (measles, mumps and rubella vaccine), influenza vaccine, and varicella vaccine have been implemented progressively. In 1988, local governments of cities and counties started to contract with local hospitals and clinics to assist in vaccination. Up to now, the contracted vaccination services have increased from the original 369 public health centers to the current 1,733 contracted medical institutions, enabling the coverage rate of each routine vaccine in Taiwan to reach 90%-95% or above. Data on annual routine vaccination services conducted by public health centers and contracted medical institutions countrywide showed that the share of vaccination services provided by public health centers had decreased from 87.5% in 1996 to 22% in 2012, while the share from contracted medical institutions had increased services from 12.5% to 78% in the same period, which meant the providers of the majority of vaccination services nowadays have shifted from public health centers to contracted medical institutions. In addition, the “Vaccine Injury Compensation Fund" was established in June, 1988. And in 1992, the “Vaccine Injury Compensation Program Working Group (VICPWG)" was organized by the Department of Health for independent deliberation. Whenever people suffered from deaths, disabilities, critical illnesses and adverse reactions induced by any vaccination, they could quickly get fair compensation after professional assessments. This helped eliminate their doubts about the possible side effects of vaccination. As of March 20, 2013, a total of 108 “Review Meetings of VICPWG " had been held to assess 1,285 applications. Among them, 498 applications were approved for compensation with the compensation rate of 38.75%. Cumulative compensation was NT $ 63,533,637 with an average of NT $ 127,578 for each application. To date, the applications for injuries from the vaccine against the 2009 H1N1 influenza virus accounted for the largest number of applications. However, BCG was the vaccine with the largest number of both approved applications and compensations for vaccine injuries, followed by the seasonal flu vaccine and DTP vaccine.