OBJECTIVES

: Pneumococcal conjugate vaccines (PCVs) have reduced the burden of pneumococcal disease around the world. The 13-valent (PCV13) and 10-valent (PCV10) vaccines are licensed for use in Thailand but are not part of the National Immunization Program (NIP). Study objective is to evaluate potential impact a PCV program could have had if implemented in 2010 when vaccines first received regulatory approval.

METHODS

: We developed a forecasting model exclusively using local Thailand data to assess the impact of introducing a PCV NIP based on the historic rates of disease impact in countries that have implemented a PCV program. Serotype specific trend estimations for invasive pneumococcal disease (IPD) were applied by age and by serotype from countries with robust surveillance to the baseline Thai incidence. The base case utilized UK trends and scenarios were evaluated using trends from other countries. Non-invasive diseases (pneumonia and acute otitis media (AOM)) were estimated based on relative changes to IPD, including antibiotic prescriptions avoided due to reductions in AOM and potentially resistant disease episodes.

RESULTS

: Assuming 90% vaccine uptake, between 2010 and 2018, a PCV13 or PCV10 NIP could have averted an estimated 79,306 or 34,512 cases of pneumococcal disease and 1,052 or 437 associated deaths in the base case, respectively. PCV13 and PCV10 were estimated to avert 13,612 to 6,992 initial antibiotic prescriptions due to AOM episodes in individuals fewer than 5 years of age, respectively. PCVs could have potentially reduced approximately 20,000 additional antibiotic prescriptions due to resistant cases.

CONCLUSIONS

: Given the significant risk of antimicrobial resistance and the morbidity and mortality associated with pneumococcal disease, implementing PCV in the Thailand NIP will have a considerable impact on public health. Further research is necessary to understand the burden of pneumococcal disease in Thailand.