Influenza vaccination guidelines and vaccine sales in southeast Asia: 2008-2011.

Vinay Gupta,Bryan K Kapella,Theresia Sandra Diah Ratih,Andrew Corwin,Sonja J Olsen,Jeffery Cutter,Chong Chee Kheong,Ly Sovann,Paul Kitsutani,Phan Trong Lan,Khin Yi Oo,Anonh Xeuatvongsa,Charung Muangchana,Remigio Olveda,Fatimah S Dawood

doi:10.1371/journal.pone.0052842

Abstract

BackgroundSoutheast Asia is a region with great potential for the emergence of a pandemic influenza virus. Global efforts to improve influenza surveillance in this region have documented the burden and seasonality of influenza viruses and have informed influenza prevention strategies, but little information exists about influenza vaccination guidelines and vaccine sales.MethodsTo ascertain the existence of influenza vaccine guidelines and define the scope of vaccine sales, we sent a standard three-page questionnaire to the ten member nations of the Association of Southeast Asian Nations. We also surveyed three multinational manufacturers who supply influenza vaccines in the region.ResultsVaccine sales in the private sector were <1000 per 100,000 population in the 10 countries. Five countries reported purchasing vaccine for use in the public sector. In 2011, Thailand had the highest combined reported rate of vaccine sales (10,333 per 100,000). In the 10 countries combined, the rate of private sector sales during 2010–2011 (after the A(H1N1)2009pdm pandemic) exceeded 2008 pre-pandemic levels. Five countries (Indonesia, Malaysia, Singapore, Thailand and Vietnam) had guidelines for influenza vaccination but only two were consistent with global guidelines. Four recommended vaccination for health care workers, four for elderly persons, three for young children, three for persons with underlying disease, and two for pregnant women.ConclusionsThe rate of vaccine sales in Southeast Asia remains low, but there was a positive impact in sales after the A(H1N1)2009pdm pandemic. Low adherence to global vaccine guidelines suggests that more work is needed in the policy arena.

Highlights

Influenza is one of the world’s most prevalent vaccine preventable diseases, responsible for three to five million cases of severe illness and 250 to 500 thousand deaths annually [1]
As demonstrated by H5N1 and the 2009 pandemic caused by the A(H1N1)2009pdm virus, investing in prevention and preparedness strategies is essential for all countries in the region
Use of seasonal influenza vaccine was extremely uncommon in Southeast Asia

Summary

Introduction

Influenza is one of the world’s most prevalent vaccine preventable diseases, responsible for three to five million cases of severe illness and 250 to 500 thousand deaths annually [1]. Over the past 10 years, there has been an increased focus on establishing more robust surveillance for influenza viruses globally with a heavy emphasis on tropical and subtropical Southeast Asia. Given the increasing trend toward urbanization in Asia [4], the resulting evolution of mega cities, and the ease of modern air travel, the spread of a lethal pandemic influenza virus is a very real possibility and cause for continued concern. Southeast Asia is a region with great potential for the emergence of a pandemic influenza virus. Global efforts to improve influenza surveillance in this region have documented the burden and seasonality of influenza viruses and have informed influenza prevention strategies, but little information exists about influenza vaccination guidelines and vaccine sales

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