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每年接種流感疫苗 預防致命流感病毒

過去三年的冬季流感季節，因流感相關而需入住深切治療部有1,316人，其中每年死亡率超過五成﹗三年總計的平均死亡率更高達六成四﹗死亡率維持在高水平是由於市民對預防流感的意識不高，認為流感不算嚴重疾病，亦不相信接種流感疫苗能有效預防流感疫症，導致持續偏低的疫苗接種率，只佔十份一人口(美國、加拿大及南韓都超過五成人口接種流感疫苗)，令本港未能達到有效防止疫症爆發的社區免疫力。

其實流感是可以致命的﹗流感亦可引起嚴重併發症或需要住院，甚至入住深切治療部。近年的流感高峰期，各間醫院的急症室及普通科門診便會因為大量市民感染流感前來求診而大排長龍。醫院病床同時出現供不應求的情況。根據世界衞生組織數據，世界各地每年患上嚴重流感人口估計有三至五百萬人，而因為流感而死亡的人口則超過二十五至五十萬人。現時，最安全和有效的預防流感及其併發症的方法仍然是接種流感疫苗，並不會因接種流感疫苗而患上流感。不接種流感疫苗而引致吉巴氏綜合症的機會可能較高，而接種流感疫苗只有百萬份一的機會。

香港醫學會今天特別舉行記者會，為醫護人員接種流感疫苗，希望鼓勵更多公營或私營服務的醫護人員接種疫苗，為個人健康把關，及提升本港整體的疫苗接種率。

香港醫學會關注醫院的醫護人手一向緊張，每年到了流感高峰時期，門診部也會擠滿病人，有部份更需要輪侯病房住院，令原本已緊張的人手更形緊絀。預防疾病是最為重要的﹗醫護人員應作好榜樣，儘早接種流感疫苗，希望將因為醫護人員患流感而休假對醫院、診所人手的影響減到最低。醫學會再次呼籲政府資助醫護人員接種預防流感疫苗。

香港醫學會副會長暨促進防疫注射服務公私營融合專責委員會主席陳以誠醫生提到今年政府增加資助小學生接種流感疫苗，可能有醫療團體或機構計劃在非診所場地提供疫苗接種服務。陳醫生呼籲參加計劃的市民和家長，應向有關單位了解注射疫苗的重要資料，例如提供服務的場地的清潔度及合適度、疫苗在運送及儲存是否有確保其冷凍鏈、是否有足夠數目合資格或已受訓的醫護人員提供服務、有否安排註册醫生或由醫生親自指導已受訓人員提供疫苗接種服務、是否提供治療接種疫苗後不良反應的設備及急救設備，及確保參與的醫護人員中有曾接受急救訓練、如何妥善處理醫療廢物及利器等。當局亦應密切關注此類社區服務的進行，以保障兒童及市民健康。

陳醫生亦強調預防醫療的重要，並向政府提出有關「長者醫療券計劃」(下稱「醫療券」)的建議，因為長者正正是感染流感高危群組中的高危一族，入院比率亦相當高，最會影響醫院於流感高峰期而產生的混亂情況。建議包括降低醫療券合資格人士年齡至65歲，與申請長者咭年齡相符、增加醫療券每年金額至4,000元及累積金額至6,000元、以及投放更多資源作公眾教育，讓更多長者使用醫療券於疫苗注射來預防疾病。根據衞生防護中心的數據，今年九月至十月出現夏季流感小高峰的延遲情況，若市民因而提早接種流感疫苗，有可能令疫苗保護期限(通常為六個月)過早結束，而未能有效預防下年的冬季流感期下旬(過往幾年均延至五月甚至六月)以至夏季流感季節來臨。陳醫生建議政府可考慮資助高危市民接種兩次流感疫苗，讓市民得到充足的保護。

防患於未然，健康人士也可能患上嚴重流感，市民必須有公德心，養成良好衞生習慣，減少傳播病毒，常用梘液洗手，更應隨身攜帶酒精潔手液，有病徵應戴口罩，並留在家中。市民應及早接種流感疫苗，為個人及家人的健康作好準備。接種疫苗後一般需要約兩星期，體內才會產生足夠抗體對抗流感。香港醫學會呼籲：

1. 政府加強有關流感疾病和疫苗的公眾教育，例如在學校課程中增加接種疫苗作疾病預防的資訊，及向市民解釋流感疫苗的安全性，加強他們的信心。
2. 全港市民特別是高危群組人士，包括所有私營或公營醫護人員，儘早接種流感疫苗以確保個人的健康得到保障。
3. 促請政府及早將流感疫苗資助計劃延伸至肥胖人士(BMI >30)及醫護人員。
4. 市民可向家庭醫生查詢有關接種季節性流感疫苗的詳情。

二零一六年十月十七日

編輯備忘：

香港醫學會成立於一九二零年，旨在聯繫政府、各公立醫療機構、大學及私人執業的醫務工作者，交流意見，團結一心。醫學會致力將最新的醫療資訊及醫務發展傳遞與會員，提倡會員遵行專業操守，進而服務社會，維護民康。

PRESS

RELEASE

17 October 2016

Annual Vaccination to Combat Deadly Influenza Virus

Figures from the past 3 winter influenza seasons showed that the mortality rate of each year was over 50% (the number of influenza-associated admissions to intensive care unit (ICU) was 1,316 in the past 3 seasons), and in average the rate reaches 64%!  The consistently high mortality rate indicates the public are not conscious of the importance on disease prevention, or believing that influenza is not a serious disease.  The public might also think that influenza vaccination is not effective enough on influenza prevention.  These misconceptions causes a steadily low vaccination uptake rate, only attains about 10% of the population (the influenza vaccination uptake rates in United States, Canada and South Korea are over 50% of the population), fall short of the threshold required for herd immunity.

Influenza can be fatal!  Influenza can also cause severe complications and results in hospitalization and even admission to ICU.  During the recent peak flu seasons, overcrowded conditions were commonly found in Accident & Emergency departments and General Outpatient Clinics by a surge in the number of patients seeking treatment for influenza.  Overcapacity of medical wards are also normally seen in hospitals.  As stated by the World Health Organization, it was estimated that influenza can result in about 3-5 million cases of severe illness, and about 250,000 to 500,000 fatal cases worldwide annually.  In present, vaccination is the most safeness and effective way for protecting against influenza infection and its complications.  One will not catch influenza from influenza vaccination.  The incidence of Guillain-Barré Syndrome (GBS) may be higher among those who do not receive influenza vaccination, while only one or two cases occurred in vaccinated persons for every 1 million vaccines. 

The Hong Kong Medical Association (HKMA) organised a Press Conference this afternoon and on-site influenza vaccination service for the healthcare professionals was arranged.  The event aimed at promoting influenza vaccination among the healthcare professionals and hoped to boost the overall vaccination uptake rate in Hong Kong.

The HKMA is concerned that hospitals often face tight healthcare manpower.  During peak flu season, outpatient department is overcrowded with patients, with some waiting for hospitalization, causing an additional burden on the already shortage manpower.  At this point, flu prevention becoming utmost important!  It is deemed that healthcare professionals should set a good example on health protection for the public in receiving influenza vaccination.  With more healthcare professionals receiving influenza vaccination, we hoped that the effect on manpower shortage due to sick leaves of influenza infection could be minimized.  The HKMA would like to call once again for the Government to provide subsidy to the healthcare professionals in receiving influenza vaccination.

Dr. Alvin YS CHAN, HKMA Vice-President cum Chairman of the Task Force on Vaccination PPI, referred to the Government’s new measure by offering subsidy to primary school students on influenza vaccination, there might be medical groups or other organizations that planned to offer influenza vaccination services in non-clinic settings.  Dr. CHAN encouraged the public and parents to find out more information about these vaccination programmes before having the injection.  For example, the cleanliness and suitability of the venue on providing such service; whether the service provider implement proper cold chain during delivering and storage; whether there are sufficient trained healthcare workers to provide the service; whether a registered doctor is arranged for administration/to supervise the trained healthcare workers for service administration; whether equipment for treating adverse drug reaction and first aid resuscitation equipment are provided and if there are healthcare workers who have received first aid training; and how the clinical waste is handled, etc.  The HKMA also recommended the Government to pay close monitoring and inspection on these programmes, so that the health of the public and children could be safeguarded. 

Dr. Alvin YS CHAN commented that preventive medicine is vital to the community.  He once again raised the proposal on “Elderly Health Care Voucher Scheme” (EHCVS) to the Government as the elderly is a vulnerable group among the high-risk groups on influenza infection.  The hospitalization rate due to influenza-like symptoms among the elderly is very high, which will affect the hospital’s operation during the peak flu seasons.  The proposal included: to lower the eligible age of the EHCVS to 65, in line with what of the Senior Citizen Card Scheme; to increase the EHCVS annual voucher amount to $4,000 and the accumulation limit to $6,000, and to allocate more resources on educating the public to utilize the EHCV on vaccinations.  According to the data from Centre for Health Protection, this year’s summer peak flu was delayed to September and October.  If the public gets vaccination too early, the vaccine efficacy might be expired soon (usually last for six months), causing a lack of protection by the end of the winter flu season (it even lasted until May or even June in the past few years) and the next summer flu season in next year.  Dr. CHAN suggested to the Government in offering 2 subsidies for each high-risk eligible citizen for influenza vaccination, so as to providing sufficient protection.

Nip it in the bud, healthy individuals can also catch flu.  Everyone should have civic virtues and establish good hygiene habit to reduce the spread of diseases, including frequent handwashing with liquid soap and bring an instant hand sanitizer.  Shall there be symptoms of influenza, one should wear a mask and stay at home.  The public should get influenza vaccination earlier to protect the health of self and family.  Normally it takes about 2 weeks after vaccination for the body to develop a sufficient level of antibodies to protect against influenza infection.  The HKMA recommends on the followings:

1. The Government should carry out public education on influenza and vaccination, such as inclusion of vaccination as a measure for disease prevention in school textbooks.  More efforts should be made on explaining to the public of the safeness of vaccines to enhance their confidence.
2. All people, especially those fall into the priority groups, including healthcare workers from both public and private sectors, should get influenza vaccinations to protect themselves.
3. The Government should extend the subsidy scheme to cover persons with obesity (BMI>30) and healthcare workers as early as possible.
4. The public can consult their family doctors for more information on influenza vaccination.

Notes to editors:

The Hong Kong Medical Association, founded in 1920, aims to bring together Hong Kong's government, institutional, university and private medical practitioners for an effective exchange of views and co-ordination of efforts.  The foremost objective of the Association is to safeguard and promote public health.  The Association speaks collectively for its members and aims to keep its members abreast of medical ethics, issues and advances around the world.  In fulfilling these goals, the association hopes to better serve the people of Hong Kong.