VaxLab Marks Another Win for Vaccine Access

A landmark decision by China’s government that will make it easier for citizens to pay for flu vaccines brings yet another milestone for Duke Kunshan University’s VaxLab, a research center that has been working to expand vaccine access and financing across Asia. 

The policy change, announced on May 19, allows workers covered under China’s Urban Employee Basic Insurance program to use individual medical savings accounts to pay for flu vaccines. It marks the first time a vaccine not included in China’s National Immunization Program (NIP) has been covered under the country’s social health insurance system, following an earlier emergency provision for COVID-19 vaccines.

“The move aligns closely with years of research and advocacy by VaxLab,” says Shenglan Tang, M.D., Ph.D., a global health professor with DKU and the Duke Global Health Institute who leads the VaxLab, formally known as the Innovation Lab for Vaccine Delivery Research. 

Housed at DKU and involving several DGHI researchers, VaxLab has been working since 2021 to build evidence for wider vaccine financing. The team published a study in a 2022 issue of Lancet Public Health showing that including vaccines in insurance plans is feasible due to reduced costs from hospitalizations and outpatient visits. A later analysis in BMJ Global Health  recommended amending China’s Healthcare Security Law to allow health insurance to cover or subsidize vaccines. 

Subsequent policy briefs called for exploring diverse financing sources, including social and commercial insurance, and a multi-tiered financing system to expand China’s NIP beyond its traditional focus on childhood immunizations. VaxLab researchers also produce some of the key evidence that led China  in 2025to add vaccines for human papillomavirus (HPV) to its NIP, the first expansion since 2008.

“We are pleased to see this important step. Including influenza vaccines under personal health insurance accounts is a feasible pathway – within the existing legal framework – to bring preventive services into the health insurance system,” Tang says.

But Tang cautions that the change affects only people covered by urban employee insurance, creating potential inequities in vaccine access. 

 “We must pay special attention to the more than 900 million Chinese residents who are not covered by urban employee health insurance. They cannot yet benefit from this policy.,” he says. “Going forward, we need to leverage National Immunization Program policy tools to help high-risk and vulnerable populations access influenza vaccines and address fair access more systematically.”