As Taiwan seeks to future-proof its healthcare system, policymakers, physicians, and industry leaders are rallying behind vaccination as a lifelong investment in both personal and national resilience.
The old adage that “prevention is better than cure” has never been more relevant to Taiwan’s public health ambitions. As the population ages and pressure mounts on the National Health Insurance (NHI) system, policymakers are adopting preventive measures as the foundation of a sustainable healthcare model.
Among the most cost-effective medical interventions ever developed, vaccination has emerged as a cornerstone of this approach. Central to President Lai Ching-te’s Healthy Taiwan initiative, immunization is viewed not only as a defense against infectious disease but also as a strategy to extend healthy life expectancy, preserve the viability of the NHI, and strengthen economic resilience.
The World Health Organization (WHO) estimates that vaccines prevent more than 30 life-threatening diseases and save between 3.5 and 5 million lives each year. In Taiwan, routine childhood immunization has virtually eliminated several once-endemic illnesses, including polio and measles, while reducing mortality from hepatitis B and tuberculosis.
Yet the nation’s success has revealed new vulnerabilities: uneven adult coverage, misinformation, and constrained budgets that threaten access to next-generation vaccines. These challenges have pushed the government, industry, and civil society to rethink how vaccination can evolve into a lifelong public-health framework.
Vaccination as the foundation
Taiwan’s National Immunization Program for children is among the most comprehensive in Asia, offering 10 publicly funded vaccines that protect against hepatitis B, tuberculosis, diphtheria, tetanus, pertussis, polio, pneumococcal disease, measles, mumps, rubella, chickenpox, and other infections. Coverage rates exceed 95%, keeping infectious-disease incidence at historic lows.
In September 2025, the Ministry of Health and Welfare (MOHW) also expanded its free HPV vaccination program to include first-year junior high school boys, making Taiwan the first economy in East Asia to provide full public coverage for both genders.
“Children’s coverage is high thanks to established vaccination networks integrated with national health system and on-campus delivery programs,” said Dr. Chen Yee-chun, director of the National Institute of Infectious Diseases and Vaccinology at the National Health Research Institutes (NHRI), at a September luncheon organized by AmCham Taiwan.
The benefits extend far beyond infection control. Hospital-admission data from the MOHW shows that 4 of the 10 leading causes of death among children and 3 among older adults are infection-related, many of them vaccine-preventable. Pneumonia alone remains the third leading cause of death for seniors and the fourth most common reason for hospitalization.
“As adult physicians, we hope the nation will invest more budget not only for children but also for adult immunization,” said Dr. Chen. “Vaccinations protect personal health, strengthen public health, and relieve the strain on the healthcare system. They are one of the most successful interventions with the highest return on investment.”
Within the Healthy Taiwan blueprint, vaccination underpins three main goals: raising life expectancy from 79 to 82 years, reducing unhealthy life years from 10% to 8% of a person’s lifespan, and lowering infant mortality to 4 per 1,000 births. Regular immunization directly supports these objectives by reducing severe illness, hospitalization, and mortality among infants and seniors — the most vulnerable groups.
Taiwan Centers for Disease Control (CDC) data shows that only 43.9% of older adults received the flu shot in early 2025, about 53% received a pneumococcal vaccine, and fewer than one in five obtained the latest Covid-19 booster.
“As adult physicians, we hope the nation will invest more budget not only for children but also for adult immunization,” Dr. Chen said.
Dr. Chang Feng-yee, chairman of the Infectious Diseases Society of Taiwan, reinforced this message from the clinical perspective. “Every dollar invested in vaccination can save about forty-four in disease burden,” he said. “In Taiwan’s NHI framework we have not always focused on return on investment — but that number speaks for itself.” He noted that prevention must be treated as a budgeting priority rather than an optional expense.
The Advisory Committee on Immunization Practices (ACIP) also approved upgrading pneumococcal vaccines for older adults, offering broader protection against invasive disease. The data supports the change: after one vaccine strand was introduced for children, cases of invasive pneumococcal disease fell 69% among those aged 0 to 5 and 37% among adults, thanks to herd immunity. By 2021, older adults accounted for more than 70% of all infections.
Other programs have followed a similar path. The annual influenza and Covid-19 campaigns, launched together each October, now prioritize high-risk populations and allow shorter booster intervals. Local governments like Taipei have introduced subsidies for shingles vaccination, while the MOHW has approved self-paid RSV vaccines for older adults, residents of care institutions, and pregnant women in their third trimester. ACIP is also considering adjuvanted and high-dose flu vaccines to strengthen immunity in seniors, underscoring the system’s gradual transition toward life-course immunization.
Funding, awareness, value
Maintaining Taiwan’s vaccination infrastructure depends on steady financing from the National Vaccine Fund, created under the Communicable Disease Control Act and funded primarily through the central government budget and a portion of tobacco tax revenue.
“Budget inputs grew versus pre-Covid but have since declined year by year,” said CDC Director-General Lo Yi-chun at the September AmCham event. “We fight annually for increases.” Lo added that this year, the CDC secured an additional NT$800 million for strengthening the vaccination workforce. That funding is now under review by the Legislative Yuan.
Under current rules, clinics receive NT$100 for each vaccine administered, but the CDC has proposed higher compensation to account for the time needed to counsel hesitant patients. Even so, Lo confirmed that “there’s no additional allocation for purchasing new vaccines this year.” The gap between service funding and investment in innovation underscores how preventive care often struggles to compete with more visible hospital-based spending.
The NHI system will soon require clinics to upload records of self-paid vaccines to a centralized database, allowing patients to maintain a complete immunization history.
“It’s not a legal mandate but a contractual requirement, similar to electronic prescription records that prevent drug interactions,” Lo said. “We hope to implement it next year.”
AmCham’s White Paper likewise recommends integrating public and private vaccination data to empower citizens and improve transparency.
Yet structural reforms must be accompanied by a shift in public perception. “Among a lot of people, vaccines were dramatized during and after Covid,” Lo said. “Many believe cancer care or other treatments are more important. Vaccination is often seen by finance stakeholders as a ‘nice-to-have.’ We need not only cost-effectiveness evidence but also public motivation.”
The CDC is studying the behavioral bias whereby publicly funded vaccines are perceived as less valuable than self-paid ones. “Strangely, when a vaccine is publicly funded, its perceived value drops — when it is expensive out-of-pocket, it appears ‘better,’” Lo said. Overcoming this paradox, he noted, will require new communication strategies.
Dr. Chen agrees that funding alone cannot sustain high coverage. “Government commitment and support is the core, but we also need knowledge dissemination and mobilization to encourage and empower the public. We need more transparency and real-world, real-time feedback.”
To strengthen trust, the CDC now issues weekly press briefings and collaborates with social-media creators to counter misinformation. “The same message is perceived differently coming from officials versus influencers,” Dr. Chen noted, adding that “AmCham and member companies can help by sharing accurate content.”
Dr. Chang noted that improving adult vaccination rates also depends on addressing these behavioral barriers. “Public perception hasn’t been entirely wrong,” he said. “For today’s elderly, traditional formulations may be less immunogenic. That’s why advanced countries now recommend high-dose or adjuvanted vaccines for seniors. Our real-world protection is closer to 3% — not enough for year-round coverage.” He argued that Taiwan should prioritize newer-generation vaccines and link prevention more explicitly to Healthy Taiwan’s broader goals.
A culture of prevention
Beyond its direct health benefits, vaccination policy has become increasingly intertwined with national resilience. Global shortages during the Covid-19 pandemic exposed Taiwan’s dependence on imported vaccines, leading to the formation of a Vaccine Industry Resilience Working Group under the Healthy Taiwan framework.
“From a geopolitical and strategic perspective, we’re focusing on building a sustainable, empowered domestic vaccine industry for long-term health security,” Lo said. “We also aim to link the industry-resilience program with the vaccine fund to share responsibilities and potentially support the National Vaccine Fund.”
Dr. Chen welcomed this initiative but emphasized that domestic capacity and capability alone cannot ensure sufficient supply. “Given the scale of vaccine-preventable diseases — even during normalcy — and the complexity of vaccine supply, we must strengthen domestic capacity and capability as well as international collaboration,” she said.
To this end, she outlined a sustainable vaccine-market framework that integrates R&D, regulation, procurement, and consumer confidence — a model balancing supply-side readiness with demand-side engagement.
For Dr. Chang, prevention remains the most effective investment in both health and system resilience. “Older adults are high-risk,” he said. “If they get infected, complications and hospitalization rise, severity increases, and medical capacity is affected — especially with current shortages of nursing and clinical staff. Prevention via vaccination is key.”
He added that infection exacerbates cardiovascular and cerebrovascular disease, prolonging disability and dependence, noting that these outcomes can be prevented with vaccination.
Dr. Chen’s own experience illustrates the broader impact of prevention. “Years ago, when my son became ill, very likely due to RSV, we couldn’t find a bed for hospitalization at National Taiwan University Hospital where I practiced,” she recalled. “Recently, my grandchild had RSV and was hospitalized and got a bed, because vaccine-preventable diseases are better controlled.”
The improvement, she noted, reflects how immunization not only saves lives but also frees hospital resources and reduces strain on healthcare workers.
AmCham Taiwan’s recommendations mirror this philosophy, calling on the government to ensure that the public budget covers at least 60% of national vaccination costs, relax restrictions on educational outreach, and maintain consistent investment in digital and workforce infrastructure. These measures, combined with ongoing industry collaboration, are designed to build what Dr. Chen describes as a culture of prevention, in which immunization is seen not as a childhood obligation but as a lifelong responsibility.
“Moving from ‘vaccine’ to ‘immunization,’ and from policy to practice, we need every stakeholder — policy, demand, and supply — at the table,” she said. “Through collaborations like today’s, we can help build a domestic and global industry ecosystem. A ‘Healthy Taiwan’ means living longer, living better, and living more actively.”
