Chinese social media have responded with outrage and fury after a Jilin-based pharmaceutical company was found to have produced and sold hundreds of thousands of substandard vaccines.

Changchun Changsheng Bio-tech Co, China’s second-largest vaccine producer, was accused of selling 252,600 doses of substandard DPT (百白破 bǎi bái pò), a vaccine for preventing diphtheria, pertussis, and tetanus, after a nine-month investigation by the Changchun drug administration.

252,600 doses of substandard DPT vaccine have been distributed to Shandong province and injected to children.

The faulty vaccines (numbered 201605014-01) have been distributed to eight cities—Jinan, Zibo, Yantai, Jining, Tai’an, Weihai, Rizhao, and Laiwu in Shandong province. Registration records from Center for Disease Control and Prevention in Shandong reveal that 215,184 children in this province have been injected with the vaccine, though the authority immediately forced a halt to the use of the vaccine at the beginning of the investigation last November, says a report from state-run media The Paper.

The company was also fined RMB 2.58 million, and RMB 859,000 in assets from sales of the vaccine were confiscated.

The scandal came days after the State Drug Administration (SDA) reprimanded Changchun Changsheng for fabricating production records for freeze-dried rabies vaccines, after Changchun police launched a thorough investigation into the company on July 15. SDA has since ordered the company to stop producing rabies vaccines, and revoked the company’s certificate for production and sales. Changchun police launched a thorough investigation into the company, with top officials being detained.

Changchun Changsheng is not the only vaccine producer involved in the scandal. In November 2017 as many as 400,520 doses of the DPT vaccine (numbered 201607050-2) produced by Wuhan Institute of Biological Products Co. Ltd. also were found to fail to meet the national standard, of which 210,000 were distributed to Hebei and the rest to Chongqing. The Center for Disease Control and Prevention in Hebei said that 143,941 children in Shijiazhuang, Langfang, and Dingzhou have been given the substandard DPT vaccine, while no details have been provided by the Chongqing municipal government as yet.

Over the past couple of days, prominent international hospitals across Beijing have made vaccine safety statements affirming that none of these faulty vaccines have been acquired within the capital. They have also stated that vaccines are procured by the Beijing Municipal Government and distributed by the Chaoyang Center for Disease Control, and that everyone should be assured of the quality and safety standards of this establishment.

Statements like this have done little to ease the worries of parents, as this scandal involving Changchun Changsheng is the third occurrence in just three years, following Wuhan Institute of Biological Products’ faulty DPT in 2017 (mentioned above), and the discovery of illegal vaccine delivery rings in 2016.

Here are answers to some of the top concerns of parents:

• How can I find out whether my child has received a substandard vaccine or not?

The vaccine booklet keeps a record of vaccine details including date given, dose, specification, and manufacturing number (supervision code), check if the manufacturing number is either 201605014-01 or 201607050-2. The manufacturing number usually includes the name of the vaccine-production company; Changchun Changsheng (长春长生) is shortened to Changsheng (长生) in this situation. (See example below)

Vaccine booklet keeps record of vaccine details including date given, dose, specification, and manufacturing number.

• What harm will a substandard vaccine do to kids?

According to the previous spokesperson from the State Bureau of Supervision of Food and Drugs, the use of a substandard DPT vaccine “doesn’t pose a safety threat to people’s health, but will reduce the expected immune effects.”

• For those children who have been injected with substandard vaccines, what should parents do?

According to the Shandong Center for Disease Control and Prevention, 208,579 children have been re-administered the DPT vaccine injection so far. The Centers for Disease Control and Prevention in Hebei and Chongqing said they would vaccinate those affected again. Whether or not those affected children need to redo the DPT vaccine depends on the analysis which is currently being carried out by the local drug administration, according to the State Center of Disease Prevention and Control.

• Besides the rabies vaccine and DPT vaccine, are other vaccines produced by Changchun Changsheng safe?

The State Drug Administration confirmed that the company’s other vaccines that are currently available on the market have been tested and no quality problems were found. The administration also launched further tests on the vaccine samples kept by the company.

Though the authority has pledged to conduct unannounced inspections on all companies that produce vaccines and implement stricter regulations, it seems that this belated action will do little to cool down people’s outrage towards the fact that children have been injected with defective vaccines, with some commenting that they will never again trust any that are domestically produced. One parent named Peng Yubin told CNN that he was thinking of getting his child injected with foreign vaccines. “Even though they are more expensive, they are better,” he said.

“The main reason [for this crisis]is slack regulation,” commentator Yang Yuze was quoted in an article found on Sixth Tone. Yang said that “the government has coddled domestic vaccine companies for too long in an effort to help them grow stronger. But instead of achieving this goal, such companies are becoming more profit-driven.”

Photos: Caixin, 童办

There are many misconceptions about rabies, the fatal disease caused by animal scratches and bites that kills around 3,000 people in China every year. I don’t have to worry about it now thanks to my family, who urged me to get vaccinated right after my dog gave me an innocuous scratch that I almost overlooked.

Days after I received one of the series of shots, some friends (both expat and local) were still confidently telling me I did not need them because my dog was vaccinated. I think that this one of the most fatal and common misconceptions. Vaccinated animals can still carry the rabies virus from direct and indirect contact with other animals, and being vaccinated only guarantees their safety from the disease.

Another misconception is that some people think scratching is not as bad as biting because the rabies virus is carried through saliva. In fact, any pet owner can tell you how often their dog or cat licks its front and hind paws. This was why, when my dog scratched my toe and broke the skin, we treated it as seriously as a bite. Under pressure from my family, I washed the exposed skin with water and soap and disinfected it with iodine solution, which later the doctor said was the right thing to do.

It is also natural to assume that you can get the vaccination at any hospital, but this is not true. I headed to Wangjing Hospital the next morning after I was scratched and was told to go to China-Japan Friendship Hospital.

Here (Chinese-only) is the list of local hospitals that you can get rabies vaccinations from in Beijing. Beijing United Family Hospital also offers rabies vaccinations.

Rabies is a viral disease transmitted by infected saliva from animals such as dogs, cats and bats through bites or scratches. It is fatal if no previous or immediate vaccination is given after contact.

For suspected patients who have never been vaccinated before, four to five doses the rabies shot are administered over a period of one month. The sooner the shots are received, the more effective the doses are. The first 24 hours after the bite/scratch is considered to be crucial, so it is better to know ahead of time which hospital to head to. In addition, go straight to the emergency department (instead of wandering around in the out-patient area).

For serious bites and scratches, rabies immunoglobulin will also be recommended by the doctor (I didn’t need this). The vaccinations (four to five doses for post-exposure; three doses for pre-exposure) are good for six months. But if the wound is bad, see a doctor regardless as a booster may be needed in some cases.

Most importantly, teach your children how to prevent bites and scratches, especially from dogs. Here are some tips from by the American Academy of Pediatrics (via myhealthbeijing.com):

• Socialize your pet. Gradually expose your puppy to a variety of people and other animals so it feels at ease in these situations.
• Train your dog. Commands can build a bond of obedience and trust between the dog and owner. Avoid aggressive games with your dog.
• Vaccinate your dog against rabies and other diseases.
• Neuter or spay your dog. These dogs are less likely to bite.
• Never leave a baby or small child alone with a dog.
• Teach your child to ask a dog owner for permission before petting any dog.
• Let a strange dog sniff you or your child before touching it and pet it gently, avoiding the face and tail.
• Never bother a dog if it is sleeping, eating or caring for puppies.
• Do not run past a dog.
• If a dog threatens you, remain calm. Avoid eye contact. Stand still or back away slowly until the dog leaves. If you are knocked down, curl into a ball and protect your face with your arms and fists.​​

Photos: Clemence Jiang and Paul Ryding