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

Optimizing national immunization program supply chain management in Thailand: An economic analysis

Objectives: This study aimed to conduct an economic analysis of the transition of the conventional vaccine supply and logistics systems to the vendor managed inventory (VMI) system in Thailand. Study design: Cost analysis of health care program. Methods: An ingredients based approach was used to design the survey and collect data for an economic analysis of the immunization supply and logistics systems covering procurement, storage and distribution of vaccines from the central level to the lowest level of vaccine administration facility. Costs were presented in 2010 US dollar. Results: The total cost of the vaccination program including cost of vaccine procured and logistics under the conventional system was US$0.60 per packed volume procured (cm) and US$1.35 per dose procured compared to US$0.66 per packed volume procured (cm) and US$1.43 per dose procured under the VMI system. However, the findings revealed that the transition to the VMI system and outsourcing of the supply chain system reduced the cost of immunization program at US$6.6 million per year because of reduction of un-opened vaccine wastage. Conclusions: The findings demonstrated that the new supply chain system would result in efficiency improvement and potential savings to the immunization program compared to the conventional system

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

Validation of the shake test for detecting freeze damage to adsorbed vaccines

OBJECTIVE: To determine the validity of the shake test for detecting freeze damage in aluminium-based, adsorbed, freeze-sensitive vaccines. METHODS: A double-blind crossover design was used to compare the performance of the shake test conducted by trained health-care workers (HCWs) with that of phase contrast microscopy as a “gold standard”. A total of 475 vials of 8 different types of World Health Organization prequalified freeze-sensitive vaccines from 10 different manufacturers were used. Vaccines were kept at 5 °C. Selected numbers of vials from each type were then exposed to −25 °C and −2 °C for 24-hour periods. FINDINGS: There was complete concordance between HCWs and phase-contrast microscopy in identifying freeze-damaged vials and non-frozen samples. Non-frozen samples showed a fine-grain structure under phase contrast microscopy, but freeze-damaged samples showed large conglomerates of massed precipitates with amorphous, crystalline, solid and needle-like structures. Particles in the non-frozen samples measured from 1 μm (vaccines against diphtheria–tetanus–pertussis; Haemophilus influenzae type b; hepatitis B; diphtheria–tetanus–pertussis–hepatitis B) to 20 μm (diphtheria and tetanus vaccines, alone or in combination). By contrast, aggregates in the freeze-damaged samples measured up to 700 μm (diphtheria–tetanus–pertussis) and 350 μm on average. CONCLUSION: The shake test had 100% sensitivity, 100% specificity and 100% positive predictive value in this study, which confirms its validity for detecting freeze damage to aluminium-based freeze-sensitive vaccines