Programme summary

We conduct applied vaccine research to help decision makers in China build a vaccination programme that ensures reliable, affordable, equitable and uninterrupted supply of vaccines to the Chinese population.

Start and end date

1 Aug 2017 to 31 Jul 2020

Aims

In China, many newer vaccines are not centrally funded, so people pay for them out-of-pocket. China is investigating whether to increase the range of vaccines that are fully funded by central government. This will require a lot of money and manufacturing capacity to supply China’s large population. Hence, authorities in China need evidence of the potential health benefits, budget impact and value for money of investments in funding new vaccines. In addition, sufficient and reliable public demand needs to be assured so that local manufacturers will ensure a reliable and uninterrupted vaccine supply. Maintaining public confidence in vaccines in the face of concerns around vaccine safety is also important.

The NIHR-funded Evidence to Policy pathway to Immunisation in China (EPIC) Global Health Research Group brings four British and Chinese public health and academic partners: the London School of Hygiene & Tropical Medicine (LSHTM), Public Health England (PHE), Chinese Centre for Disease Control and Prevention (China CDC) and Fudan University (Fudan). EPIC’s structure is inspired by the NIHR-funded Health Protection Research Unit in Immunisation, in which LSHTM and PHE jointly conduct research to inform UK vaccine policy.

Together, we conduct applied vaccine research that will help decision-makers in China build a vaccination programme that ensures reliable, affordable, equitable and uninterrupted supply of vaccines to the Chinese population.

Our work spans three themes:

1. Collecting and analysing data about health and economic consequences of vaccine-preventable diseases in China
2. Understanding vaccine supply, demand and decision making among the public, manufacturers and key stakeholders
3. Using findings from themes (1) and (2) in mathematical models to project the health and economic impact that vaccine introduction could have, particularly among the groups with the worst health. We will focus research around vaccines that are of most interest to decision-makers but are not currently centrally funded

We aim for EPIC to inspire similar models of research to inform immunisation policy elsewhere in Asia. We will publicise key insights from this collaborative work widely, and hold workshops in Asia towards the end of the grant to share lessons learnt with other Asian countries. Through these channels, we will invite partners outside China to explore funding opportunities to establish similar models in other countries.

Partners and collaborators

• Chinese Center for Disease Control & Prevention, China
• Fudan University, China 
• Public Health England

EPIC will be a collaboration between the UK and China involving reciprocal exchanges of staff. Scientists in China draw on British expertise as they design studies to collect and analyse data. Chinese PhD students and visiting scientists come to LSHTM and PHE and are supervised by UK experts to conduct analyses and build models. British scientists work with teams in China to gain a deep understanding of vaccine epidemiology, data collection and policy making in China. Findings will be presented to key groups in China responsible for making decisions about vaccine delivery.

On 3-7 June 2019, NIHR EPIC organized a visit by leaders involved in decision-making and implementation of the national immunisation programme in China. The delegation was led by Dr Zijian Feng, Deputy Director-General of the Chinese Center for Disease Control and Prevention (China CDC). The Chinese delegation spent 5 days in London, and had the opportunity to interact with key policy-makers, public health officials and researchers from Public Health England (PHE), LSHTM, NHS England, NIHR and the Greater London Authority.

The purpose of the visit was to:

• Exchange knowledge about the current public health practice of the national immunization program and vaccination services in UK and China;
• Discuss and demonstrate how policy-relevant immunization research provides evidence to inform vaccine policy
• Strengthen the relationship between Public Health England and China CDC in immunization

Highlights of the five days included:

• A visit to PHE Wellington House to meet officers from PHE, the Greater London Authority and NHS England to exchange knowledge about the current immunization and vaccination services in UK and China
• An off-site visit to a local vaccination clinic to deepen the understanding of how vaccination services are carried out and well monitored in UK
• A visit to PHE Colindale to attend a workshop of role of JCVI in the UK and NIAC in China, including demonstration of the work undertaken in the Immunization Service at PHE and challenges of new vaccine introduction in China
• Observing the Joint Committee on Vaccination and Immunization meeting
• Participating in the annual scientific advisory board meeting to guide the strategic direction of NIHR EPIC
• A visit to LSHTM to attend the Vaccine Centre UK-China symposium: evidence to inform vaccine policy, which provided an opportunity for scientific exchange between Chinese delegates and researchers at LSHTM. The event showcased policy- relevant immunization research carried out at LSHTM, PHE, China CDC and Fudan University, with focus on immunization in China and the UK

On 12-14 August 2019, NIHR EPIC members from LSHTM, Fudan University and the University of Hong Kong organized a training workshop on infectious disease modelling to build capacity in this area in China. The workshop was held at Fudan University in Shanghai and attracted 65 attendees from universities and public health institutions across China.

The course covered a wide range of topics including modelling transmission of infectious diseases, health economic analysis, geospatial modelling and phylodynamic analyses.

Mark Jit, the Director of NIHR EPIC, participated in the 8th HTAsiaLink Annual Conference in Seoul, South Korea on 24-27 April 2019 in order to generate awareness and interest in the work of NIHR EPIC. This was the opportunity to organise a workshop on “Conducting economic evaluations of vaccination: lessons from the field and opportunities for further collaboration”. The aim of the workshop was to explore interest from participants in being part of a proposal to extend NIHR EPIC to other countries in the region, as requested by NIHR.

The workshop was attended by 39 participants from Australia, Canada, China, India, Kenya, Malaysia, the Philippines, South Korea, Singapore, Switzerland, Taiwan, Thailand, the United Kingdom and Vietnam. Many of the participants were from key health technology agencies in the region such as the National Evidence-based Healthcare Collaborating Agency (NECA) in South Korea, Health Intervention and Technology Assessment Program (HITAP) in Thailand, the Center for Drug Evaluation in Taiwan and the Malaysian Health Technology Assessment Section (MAHTAS) in Malaysia.

Many of the participants expressed interest in being part of future NIHR research funding proposals, and we will contact them when the opportunities arise.