According to the EPI, category one vaccines are purchased by the government and provided to the public at no cost, while category two vaccines are voluntary for which citizens would usually have to pay out of their own pocket. Such system has led to two parallel market for the vaccination industry, with one being the public market with tighter control in general and another being the private market. Data has showed that the public market size has been shrinking since 2013 while the private market was growing slowly. In 2017, the private market for vaccines in China was seven times of the public market, where the difference was forecasted to grow even further in the next decade. According to forecasts, the Japanese encephalitis vaccines market in China would account for more than half of the global market by 2022.
Unfortunately, there have been multiple incidents happened in the last decade where substandard, counterfeit or expired vaccinations were distributed to the public, leading to infants fatalities, side-effects in children and public outrage for the quality assurance of vaccinations. Consequently, at some periods parents were skeptical at letting their children inoculated and some citizens have resorted to medical tourism abroad. The Chinese government has received a lot of criticism on the monitoring and controlling of vaccine and has been reforming the sector as a result. One of the main vaccination manufacturers involved in the scandals, Changsheng, was fined with a record 1.3 billion U.S. dollar by the government, while a dozens of officials were disciplined and some executives were arrested.
In the meantime, a first draft of the vaccine management law has been released for public consultation in November 2018, which would impose tighter penalties and control over the whole vaccines industry in China once the law would be passed by the Congress.