中國二類疫苗大面積短缺
Chinese parents are being refused vaccines for their children as shortages force doctors to ration supplies, amid government attempts to cut out private middlemen following a vaccine safety scandal this year.
中國的父母帶孩子打疫苗正在遭到拒絕，因爲疫苗短缺迫使醫生限量供應。今年曝出疫苗安全醜聞後，中國政府試圖取締私人中間商。
Parents have resorted to travelling from clinic to clinic in search of vaccines, with some turned away until September when a new distribution system is expected to come online.
父母們不得不一家接一家接種機構地尋找疫苗，有些人只能等到9月，屆時新的配發制度有望出臺。
“I was angry but couldn’t do anything other than wait,” said Tang Zhiming, who was turned away from several clinics in the southern city of Guangzhou when he tried to get shots for his three-year-old.
唐志明（音譯）表示：“我感到憤怒，但除了等待之外別無他法。”他在廣州嘗試爲3歲的孩子接種疫苗時遭到數家接種機構拒絕。
The supply shortage is “temporary” and caused by “work integration issues”, the China Food and Drug Administration said this month, adding that “national production can meet market demand”.
中國國家食品藥品監督管理總局本月表示，供應短缺是“暫時性的”，是“工作銜接”造成的，並表示“我國疫苗生產能力可滿足市場需求”。
Distribution is now among the main challenges for the vaccine programme, after the abrupt removal of middlemen. This month Beijing kicked off tenders that normally take place in the winter but were delayed by the uncertainties of the new system.
在突然取締中間商之後，疫苗現在面臨的主要挑戰之一是配發問題。中國政府本月啓動了疫苗招標工作。招標通常在冬季進行，但由於新制度的不確定性而延遲。
In March Chinese media revealed that police in eastern Shandong province had last year cracked a ring of private wholesalers who had sold $88m in expired or spoiled vaccines to local centres for disease control throughout China.
今年3月，中國媒體披露，山東警方去年破獲了一系列私人疫苗批發商非法經營案。這些批發商向各地疾控中心銷售了8800萬美元的過期或變質疫苗。
In response, Beijing mandated producers to sell directly to local CDCs. But delays and uncertainties in implementing its new system have caused supply to local clinics to dry up. The shortages have mostly hit “Class II” vaccines which — unlike state-mandated Class I vaccines — are optional and paid out of pocket and were a main source of revenue for the CDCs.
中國政府因此要求生產廠家直接向地方疾控中心銷售疫苗。但執行新制度的延遲和不確定性導致地方疾控中心供應枯竭。短缺的主要是“二類”疫苗。與政府強制要求接種的“一類”疫苗不同，“二類”疫苗是自願選擇接種、並且是自費的，是疾控中心的主要收入來源。
The policy scrapping “flexible” vaccine sales and distribution channels in favour of new CDC procurement platforms was “a little bit too hasty”, said Shanghai-based vaccine expert Tao Lina. “This type of transition should not happen overnight, it should be a long process.”
上海疫苗專家陶麗娜（音譯）表示，爲了新的疾控中心採購平臺，而出臺取締“靈活的”疫苗銷售和配送渠道的政策“有些過於倉促”，“這種轉變不應一夜之間發生，它應該是一個長期的過程”。
The crackdown on the Shandong-based ring was kept quiet for almost a year, for fear it would erode confidence in Chinese vaccines among the Chinese public and foreign export markets.
由於擔心破壞中國公衆和外國出口市場對中國疫苗的信心，山東疫苗案破獲近一年後才公諸於衆。
Pharmaceutical industry officials told the Financial Times this month they had been aware of the scandal before Chinese media reported it. Nonetheless, health authorities only attempted to trace potential victims after the reports.
製藥行業官員本月告訴英國《金融時報》，他們在中國媒體報道之前就已知曉這樁醜聞。然而，衛生主管部門在媒體報道之後纔開始努力找到潛在的受害者。
High levels of vaccination in Chinese children will probably protect against serious disease outbreaks while the government sorts out the new distribution system, said Dr Lawrence Rodewald, the World Health Organisation’s vaccine specialist in Beijing.
世界衛生組織(WHO)駐北京疫苗專家勞倫斯•羅德瓦爾德博士(Dr Lawrence Rodewald)表示，在中國政府梳理新的配發制度期間，中國孩子的高接種率或能預防嚴重的疾病爆發。
Vaccine producers and public health officials complain of red tape and marketing networks that are not set up to cope with 2,900 county-level CDCs. “Gaps” have appeared in the supply chain — in which vaccines must be kept in a narrow temperature range — when producers have to ship directly to small CDC facilities. The new policy requires vaccine tenders to be conducted via provincial procurement platforms, which have been set up by only a few provinces.
疫苗生產商和公共衛生官員抱怨存在各種繁瑣的手續，以及沒有建立起應對2900家縣級疾控中心的營銷網絡。當生產商不得不直接向小型疾控中心配送疫苗時，供應鏈出現“缺口”——疫苗保存有嚴格的溫度範圍。新政策要求二類疫苗必須通過省級採購平臺招標，而現在只有少數省份建立起招標採購平臺。
“Provincial CDCs told us that they don’t have the procurement platforms in place, they haven’t updated their systems and, most importantly, they haven’t fully digested or understood the new policy,” said Ms Ding, an executive at a vaccine producer in south-west China, who asked to be identified only by her surname. “They couldn’t start the tender process and as a result we couldn’t sell vaccines to them.”
中國西南一家疫苗生產商的丁姓高管表示：“省疾控中心告訴我們，他們還沒有建立起採購平臺，還沒有升級系統，而且最重要的是，他們沒有完全消化或理解新政。”這位只肯透露姓氏的高管表示：“他們無法啓動招標流程，結果是我們無法向他們銷售疫苗”。
Contributing to the shortage is the removal of Class II vaccines as a source of revenue for the local CDCs, which makes them less willing to hold stocks. The drop in orders caused some producers to scale down output, according to people in the pharmaceutical industry.
二類疫苗短缺的部分原因還在於它們不再是地方疾控中心的收入來源，這讓後者不太願意保持庫存。製藥業人士表示，訂單下降導致一些生產商削減了產量。
