CHINA’S VACCINE SCANDAL THREATENS PUBLIC FAITH IN IMMUNIZATIONS

[The scandal is just the latest crisis to shake public faith in China’s food and medicine supplies, but it is the first big scare under Mr. Xi, who had vowed to be different. He had come into office promising to “make protecting the people’s right to health a priority.”]

By Chris Buckley

Officials with the China Food and Drug Administration checking vaccines last

month at a clinic in Rong’an County, in the southern region of Guangxi.

Credit Tan Kaixing/European Pressphoto Agency

HEZE, China — First the news rippled across China that millions of compromised vaccines had been given to children around the country. Then came grim rumors and angry complaints from parents that the government had kept them in the dark about the risks since last year.

Now, the country’s immunization program faces a backlash of public distrust that critics say has been magnified by the government’s ingrained secrecy.

Song Zhendong, like many parents here, said he was reluctant to risk further vaccinations for his child, a 10-month-old boy he cradled in his arms.

“If he can avoid them in the future, we will not get them,” said Mr. Song, a businessman. “Why didn’t we learn about this sooner? If there’s a problem with vaccines for our kids, we should be told as soon as the police knew. Aren’t our children the future of the nation?”

The faulty vaccines have become the latest lightning rod for widespread, often visceral distrust of China’s medical system, as well as a rebuff to what many Chinese critics see as President Xi Jinping’s bulldozing, top-down rule.

The scandal is just the latest crisis to shake public faith in China’s food and medicine supplies, but it is the first big scare under Mr. Xi, who had vowed to be different. He had come into office promising to “make protecting the people’s right to health a priority.”

“If our party can’t even handle food safety properly while governing China, and this keeps up, some will wonder whether we’re up to the job,” Mr. Xisaid in 2013, the year he became president.

About two million improperly stored vaccines had been sold around the country from an overheated, dilapidated storeroom. The main suspect in the case is a hospital pharmacist from Heze who had been convicted of trading in illegal vaccines in 2009 and was doing it again two years later.

Many parents said they were especially alarmed that nearly a year had elapsed from the time the police uncovered the illicit trade and the time the public first learned about it in February.

“Withholding information doesn’t maintain public credibility,” said Li Shuqing, a lawyer in Jinan, the capital of Shandong Province, who is one of about 90 attorneys who have volunteered to represent possible victims in the case. “In the end, it makes people more distrustful.”

To many here, the combination of lax regulation and the secrecy surrounding a potential public health crisis seems like déjà vu.

In the SARS crisis of 2003, 349 people died across mainland China and hundreds more died elsewhere after officials hid the extent of its spread. In a scandal that came to light in 2008, at least six children died and 300,000 fell ill with kidney stones and other problems from infant formulaadulterated with melamine, an industrial chemical.

“The customers worry about fake milk powder, fake medicine, fake vaccines, fake everything,” said Ma Guohui, the owner of a shop on the rural fringe of Heze that sells baby products. “This is certainly going to affect people’s thinking. My boy got all his vaccination shots. If he were born now, I’d worry.”

Despite such fears, the tainted vaccines are more likely to be ineffective than harmful.

The World Health Organization has said that outdated or poorly stored vaccines rarely if ever trigger illness or toxic reactions. Chinese government investigators said last week that they had not found any cases of adverse reactions or spikes in infections linked to ineffective vaccines.

The greater danger may be more insidious. The erosion of public trust could damage China’s successful immunization program, which has been credited with dramatic declines in measles and other communicable diseases.

“Confidence is easy to shake, and that’s happened across the world and has happened here,” said Lance Rodewald, a doctor with the World Health Organization’s immunization program in Beijing. “We hear through social media that parents are worried, and we know that when they’re worried, there’s a very good chance that they may think it’s safer not to vaccinate than to vaccinate. That’s when trouble can start.”

After unfounded reports of deaths caused by a hepatitis B vaccine in 2013, such vaccinations across 10 provinces fell by 30 percent in the days afterward, and the administration of other mandatory vaccines fell by 15 percent, according to Chinese health officials.

The illicit vaccines in the current case were not part of China’s compulsory, state-financed vaccination program, which inoculates children against illnesses such as polio and measles at no charge.

The illegal trade dealt in so-called second-tier vaccines — including those for rabies, influenza and hepatitis B — which patients pay for from their own pockets.

The pharmacist named in the investigation, Pang Hongwei, bought cheap vaccines from drug companies and traders — apparently batches close to their expiration dates — and sold them in 23 provinces and cities, especially in rural eastern and central China, according to drug safety investigators.

She began the business in 2011, just two years after she had been convicted on charges of illegally trading in vaccines and sentenced to three years in prison, which was reduced to five years’ probation. Officials have not explained how she was able to avoid prison and resume her business.

Ms. Pang, in her late 40s, and her daughter, who has been identified only by her surname, Sun, kept the vaccines in a rented storeroom of a disused factory in Jinan. The storeroom lacked refrigeration, which may have damaged the vaccines’ potency. The police have detained them but not announced specific charges, and neither suspect has had a chance to respond publicly to the accusations.

Lax regulation in the second-tier commercial system allowed Ms. Pang’s business to grow, several medical experts said. Local government medical agencies and clinics were able to increase their profits by turning to cheap, illegal suppliers, People’s Daily, the official party paper, reported Tuesday.

Police investigators discovered Ms. Pang’s storehouse last April, but word did not get out to the public until a Shandong news website reported on the case in February of this year. Most Chinese had still heard nothing about it until another website, The Paper, published a report that drew national attention a month later.

It was the government’s intolerance of public criticism, critics said, that kept the scandal under wraps, a delay that now makes it harder to track those who received the suspect injections.

“We’ve seen with these problem vaccines that without the right to know, without press freedom, the public’s right to health can’t be assured,” said Wang Shengsheng, who is one of the lawyers pressing the government for more answers and redress over the case.

In the last few weeks, official reticence has been supplanted by daily announcements of arrests, checks and assurances as the central government has scrambled to dampen public anger and alarm.

Premier Li Keqiang ordered central ministries and agencies in March to investigate what had gone wrong.

Last week, the investigators reported that 202 people had been detained over the scandal, and 357 officials dismissed, demoted or otherwise punished. Health and drug officials promised to tighten vaccine purchase rules to stamp out under-the-counter trade.

“How could this trafficking in vaccines outside the rules spread to so many places and go on for so long?” Mr. Li said, according to an official account. Without decisive action, he said, “ordinary people will vote with their feet and go and buy the products they trust.”

Mr. Xi has so far not publicly commented on the scandal.

Dr. Rodewald, the World Health Organization expert, said the proposed changes were promising and would mean clinics would not have to rely on selling patient-paid vaccines for their upkeep.

Xu Huijin, a doctor in Heze, said that the concern over the scandal — and unfounded rumors of deaths — had depressed the number of parents bringing children to her clinic for inoculations.

“This was badly handled,” she said. “There was a lack of coordination, not enough information. We should have found out about this long ago. Doctors are taught to tell patients the full facts.”

Follow Chris Buckley on Twitter @ChuBailiang.

Adam Wu contributed research from Beijing.

@ The New York Times