從公共衛生倫理觀點看臺灣公費流感疫苗擴大接種政策

Public Health Ethics of Expanded Program on Government-funded Influenza Immunization in Taiwan

黃喬煜(Chiao-Yu Huang) ； 吳建昌(Kevin Chien-Chang Wu) ； 郭冠良(Kuan-Liang Kuo,) ； 吳岱穎(Tai-Yin Wu)

《北市醫學雜誌》 14卷2期 (2017/06) Pp. 129-138

https://doi.org/10.6200/TCMJ.2017.14.2.01

摘要

流行性感冒是世界上重要的公共衛生及健康議題，每年度的三價流感疫苗接種流感疫苗施打是世界衛生組織認定最有效預防流感疫情的防疫策略，國際間針對流感疫苗的施打政策因國情考量各有不同。台灣自1988 年起開始實施流感疫苗接種計畫，考量2015 年度因流感重症造成的重大健康及社會經濟損失，台灣於2016 年度實施公費流感疫苗擴大接種政策，將公費疫苗接種對象擴展到50 歲以上成人、青少年及其他族群，也因此衍生許多在疫苗效益、風險及資源分配上的討論議題。公共衛生倫理是用來了解和澄清公共衛生政策推動和制訂的價值和原則。本文回顧相關文獻，將根據公共衛生倫理分析架構來針對「擴大接種政策的效益」、「接種政策的可能傷害」及「資源分配等」三個議題進行剖析，並進行正反面討論。

關鍵字

流行性感冒 ； 流感疫苗 ； 公費疫苗 ； 擴大疫苗接種政策 ； 公共衛生倫理

並列摘要

Seasonal influenza is a serious public health problem that causes severe illness and death around the world. Annual vaccination is one of the most effective ways recognized by WHO to prevent the epidemics. However, the vaccination policy differs across countries concerning the condition differences across countries. Government-funded influenza vaccination program was initiated in Taiwan since 1988. Since influenza epidemics imposed great burdens on public health and economics in Taiwan in 2015-2016 influenza season, Taiwan initiated an expanded program on immunization against influenza in this period. The program expanded new target groups: children aged 6 months to 18 years, postnatal women, and adults aged 50 and above. Controversies regarding effectiveness, risk management and distributive justice of this vaccination program soon emerged. We systemically reviewed literature and upto- date evidence and disserted issues on expanded vaccination effectiveness, possible harm and resource allocation based on a framework of public health ethics. This article highlights the value of the influenza vaccination program and provides practical suggestions for future policy making.

並列關鍵字

Influenza ； Influenza vaccine ； Government-funded vaccination ； Expanded program on immunization ； Public health ethics