Potential changes in vaccine access and policy landscape in Thailand post COVID-19 pandemic.

The COVID-19 pandemic has had a dramatic impact on society, but little is known about how the pandemic affects the vaccine policy landscape and public perception of vaccines in Thailand. This study aims to describe potential changes in Thailand's policy landscape post-pandemic. We performed a literature review and in-depth interviews with 12 key informants to understand the policy landscape in Thailand. The findings were shared in a policy forum in December 2021. Several key findings were summarized. Funding and development have been thriving during the pandemic. However, a long-term commitment from all stakeholders is required to maintain policy continuation. A public-private partnership should be considered. The regulatory body needs to be prepared for product authorization. The vaccine introduction decision-making process, and investment in prevention and promotion, should further be discussed. In summary, it is important to reshape the environment and mentality of all stakeholders to create a sustainable and self-sufficient vaccine ecosystem.

Economic Evaluation and Budget Impact Analysis of Vaccination against Haemophilus influenzae Type b Infection in Thailand.

Current study aimed to estimate clinical and economic outcomes of providing the Haemophilus influenzae type b (Hib) vaccination as a national vaccine immunization program in Thailand. A decision tree combined with Markov model was developed to simulate relevant costs and health outcomes covering lifetime horizon in societal and health care payer perspectives. This analysis considered children aged under 5 years old whom preventive vaccine of Hib infection are indicated. Two combined Hib vaccination schedules were considered: three-dose series (3 + 0) and three-dose series plus a booster does (3 + 1) compared with no vaccination. Budget impact analysis was also performed under Thai government perspective. The outcomes were reported as Hib-infected cases averted and incremental cost-effectiveness ratios (ICERs) in 2014 Thai baht (THB) ($) per quality-adjusted life year (QALY) gained. In base-case scenario, the model estimates that 3,960 infected cases, 59 disability cases, and 97 deaths can be prevented by national Hib vaccination program. The ICER for 3 + 0 schedule was THB 1,099 ($34) per QALY gained under societal perspective. The model was sensitive to pneumonia incidence among aged under 5 years old and direct non-medical care cost per episode of Hib pneumonia. Hib vaccination is very cost-effective in the Thai context. The budget impact analysis showed that Thai government needed to invest an additional budget of 110 ($3.4) million to implement Hib vaccination program. Policy makers should consider our findings for adopting this vaccine into national immunization program.

Effectiveness of mouse brain-derived inactivated Japanese encephalitis vaccine in Thai National Immunization Program: a case-control study.

Mouse brain-derived, purified inactivated Japanese encephalitis vaccine (MB JEV) has been locally produced and introduced into Thai National Immunization Program (NIP) since 1990. However, MB JEV effectiveness has been concerned, since 30-40% of JE cases received JE vaccines were recently reported in two descriptive studies. Therefore, in 2010, a case-control study was designed to assess effectiveness of the MB JEV used in the NIP, among children aged 1 to <6 years. Subjects enrolled from all regions of the country, 26 cases were clinical encephalitis with laboratory-confirmed for JE IgM titer, while 103 controls had past illness free on encephalitis. For each case, four controls were enrolled from children living in the same community with the case. Individual health records of the subjects were used to verify JE immunization status. Among children aged ≥ 18 months old, the recommended age by the NIP, the effectiveness was estimated at 94.6% (95%CI, 79.6-98.6%) and adjusted effectiveness was 97.50% (95%CI, 88.60-99.50%). The study results suggest that the MB JEV used in the NIP is highly effective, even among children aged <18 months. Therefore, aggressive immunization using the MB JEV would greatly diminish disease burden.

Exposure to heat and freezing in the vaccine cold chain in Thailand.

This study investigated exposure to heat and freezing of vaccines used in Thailand's National Immunization Program. Cold chain temperatures on 48 randomly selected shipment routes nationwide were monitored. Measles and hepatitis B vaccines were despatched with recording devices and subsequently tested. The study found that extremes of cold appear to be the more significant problem. Heat exposure was relatively brief and not at very high temperatures, so vaccine deterioration was unlikely, as was confirmed by measles vaccine testing. Exposure to temperatures below -0.5 degrees C was widespread, which would be expected to damage hepatitis B vaccine, but shake tests did not detect damage.