Antibodies against measles and rubella virus among different age groups in Thailand: A population-based serological survey.

Measles and rubella are highly contagious viral diseases transmitted via respiratory secretions and aerosolized droplets. Thailand has implemented universal vaccination against measles using the monovalent measles (M) or the trivalent measles-mumps-rubella (MMR) vaccine for the past 30 years. Nevertheless, incidence of measles and rubella remains in some parts of the country. We conducted a seroprevalence study to evaluate the antibodies to measles and rubella virus among Thais of all ages and to determine pre-existing immunity resulting from either vaccination and/or natural exposure. A total of 1,781 serum samples collected in 2014 was tested for IgG to measles and rubella virus by commercial enzyme-linked immunosorbent assays (ELISA). Percentages of individuals with protective antibody levels and the geometric mean concentrations (GMC) of IgG in each age group were analysed. The GMC of anti-measles IgG and anti-rubella IgG were 653.7 IU/L (95% confidence interval (CI); 555.9-751.4) and 39.5 IU/mL (95% CI;35.0-43.9), respectively. Thais between the ages of six months and 25 years did not demonstrate sufficient protective herd immunity for measles. This observation is consistent with the recent measles outbreaks in this age group. Lower prevalence of immunity against rubella was found among children ages 5-6 years who may not have completed vaccination as infants. Our findings identify gaps in rubella and measles immunity in specific age groups and support recommendations for catch-up MMR vaccination in individuals 30 years of age or younger

Seasonal influenza vaccine coverage among high-risk populations in Thailand, 2010–2012

AbstractBackgroundThe Advisory Committee on Immunization Practice of Thailand prioritizes seasonal influenza vaccinations for populations who are at highest risk for serious complications (pregnant women, children 6 months–2 years, persons ≥65 years, persons with chronic diseases, obese persons), and healthcare personnel and poultry cullers. The Thailand government purchases seasonal influenza vaccine for these groups. We assessed vaccination coverage among high-risk groups in Thailand from 2010 to 2012.MethodsNational records on persons who received publicly purchased vaccines from 2010 to 2012 were analyzed by high-risk category. Denominator data from multiple sources were compared to calculate coverage. Vaccine coverage was defined as the proportion of individuals in each category who received the vaccine. Vaccine wastage was defined as the proportion of publicly purchased vaccines that were not used.ResultsFrom 2010 to 2012, 8.18 million influenza vaccines were publicly purchased (range, 2.37–3.29 million doses/year), and vaccine purchases increased 39% over these years. Vaccine wastage was 9.5%. Approximately 5.7 million (77%) vaccine doses were administered to persons ≥65 years and persons with chronic diseases, 1.4 million (19%) to healthcare personnel/poultry cullers, 82,570 (1.1%) to children 6 months–2 years, 78,885 (1.1%) to obese persons, 26,481 (0.4%) to mentally disabled persons, and 17,787 (0.2%) to pregnant women. Between 2010 and 2012, coverage increased among persons with chronic diseases (8.6% versus 14%; p<0.01) and persons ≥65 years (12%, versus 20%; p<0.01); however, coverage decreased for mentally disabled persons (6.1% versus 4.9%; p<0.01), children 6 months–2 years (2.3% versus 0.9%; p<0.01), pregnant women (1.1% versus 0.9%; p<0.01), and obese persons (0.2% versus 0.1%; p<0.01).ConclusionsFrom 2010 to 2012, the availability of publicly purchased vaccines increased. While coverage remained low for all target groups, coverage was highest among persons ≥65 years and persons with chronic diseases. Annual coverage assessments are necessary to promote higher coverage among high-risk groups in Thailand

Do Thai Physicians Recommend Seasonal Influenza Vaccines to Pregnant Women? A Cross-Sectional Survey of Physicians’ Perspectives and Practices in Thailand

<div><p>Background</p><p>Physicians play a major role in influencing acceptance and uptake of vaccines. However, little is known about physicians’ perspectives on influenza vaccination of pregnant women in Thailand, for whom vaccine coverage is estimated at <1%.</p><p>Method</p><p>In 2013, a self-administered questionnaire on physicians’ perceptions, attitudes and practices related to influenza vaccination for pregnant women was distributed to 1,134 hospitals with an antenatal care clinic (ANC) in Thailand. At each hospital, one physician working at the ANC completed the survey. Predictors of routine recommendation of influenza vaccine were analyzed utilizing log-binomial regression.</p><p>Results</p><p>A total of 580 (51%) complete responses were received from physicians practicing at ANCs. A favorable attitude towards vaccination was expressed by 436 (75%) physicians, however only 142 (25%) reported routinely recommending influenza vaccine to pregnant women in their current practice. Physicians were more likely to recommend influenza vaccine routinely when they had more than three years of practice (prevalence ratio [PR] 1.9, 95% CI 1.2–2.3), had treated pregnant women for influenza (PR 1.8, 95% CI 1.3–2.7), perceived the influenza vaccine to be effective (moderate level: PR 1.6, 95% CI 1.1–2.4; high level: PR 1.9, 95% CI 1.3–2.9) and were aware of the Ministry of Public Health’s (MOPH) recommendation of influenza vaccination in pregnancy (PR 1.3, 95% CI 1.1–1.7). Vaccine not being available, perception that policy was ambiguous and lack of awareness of MOPH recommendations were the most commonly cited barriers to routine recommendation of influenza vaccine.</p><p>Conclusion</p><p>Despite a national policy to vaccinate pregnant women for influenza, only 25% of Thai physicians working in ANCs routinely recommend vaccination. Strategies are needed to increase vaccine availability and free vaccine services, address clinician concerns over vaccine effectiveness and expand healthcare provider awareness of MOPH recommendations.</p></div

Open-ended responses of Thai physician to perceived barriers of influenza vaccination of pregnant women.

<p>Open-ended responses of Thai physician to perceived barriers of influenza vaccination of pregnant women.</p

Characteristics of Thai physician respondents and their perspectives on influenza vaccine (N = 580).

<p>Characteristics of Thai physician respondents and their perspectives on influenza vaccine (N = 580).</p

Associated factors for vaccine recommendation among respondent physicians (N = 543).

<p>Associated factors for vaccine recommendation among respondent physicians (N = 543).</p

Key perceptions of Thai physicians related to influenza vaccination (N = 580).

<p>Key perceptions of Thai physicians related to influenza vaccination (N = 580).</p

Comparison of key perceptions among Thai physicians who recommend influenza vaccine and those who don’t in hospitals with influenza vaccine services (N = 543).

<p>Comparison of key perceptions among Thai physicians who recommend influenza vaccine and those who don’t in hospitals with influenza vaccine services (N = 543).</p

Comparison of reasons for not recommending vaccines to pregnant women by Thai physicians in public and private hospitals (N = 401).

<p>Comparison of reasons for not recommending vaccines to pregnant women by Thai physicians in public and private hospitals (N = 401).</p