Typhoid Vaccine Used in Vietnam and its Impact Typhoid Vaccine iآ  Typhoid Vaccine Used in Vietnam...

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Transcript of Typhoid Vaccine Used in Vietnam and its Impact Typhoid Vaccine iآ  Typhoid Vaccine Used in Vietnam...

  • Typhoid Vaccine Used in Vietnam and its Impact

    Ad-Hoc Consultation on Typhoid Vaccine Introduction and Typhoid Surveillance,

    18-20 April 2011, Bangkok, Thailand Nguyen Van Cuong, Deputy NEPI Manager

  • Vietnam

    # population: 86 m.

    # < 1 year old: 1.6 m.

    # regions: 4

    # provinces: 63

    # districts: 695

    # communes: 11,138

  • EPI vaccines in Vietnam Vaccine Schedule Year start % Coverage

    area 2010 BCG Birth 1981 100

    DPT-HepB-Hib M2, M3, M4 2010 100

    DPT M18 2011 100

    OPV M2, M3, M4 1981 100

    Measles M9, M18 1981 100

    HepB Birth 1997 100

    JE M12, +W2; Y2 1997 80

    Typhoid Y3-Y5 1997 5

    Cholera Y2-Y5 1997 2

    TT PW; +M1; +M6; +Y1; +Y1 1981 100

  • Typhoid vaccine in EPI 1997 - 2010

    Company Year # doses (x1000) Type vaccine

    Aventis Pasteur

    1997 - 2003: 3 - 5 Y 4,300 TYPHIM Vi

    IVAC/ DAVAC (Vietnam)

    2004 - 2010: 5 - 10Y

    2011: 3-5Y 2,080 Typhoid Vi polysaccharide

    Total 6,380

  • Estimated Average Annual Incidence of Typhoid, 1999-2003 (DOMI program)

     Average annual number of cases nation-wide, all ages (1999-2003): 11,696

     Average annual incidence rate: 14.7 per 100,000

    Out of 61 provinces:  2 have high over incidence

    (>100/100,000) in all age groups combined.

     18 have medium incidence (10 – 100/ 100,000)

  • Age Groups

    Age group (years)

    Avg. Annual incidence/ 100,000

    (1999-2003)

    Percent

    < 2* -- -- 2-4 26.5 21% 5-9 39.4 31% 10-14 31.8 25% 15-19 11.3 9% 20-29 11.1 9% 30-39 3.8 3% 40 and over 2.4 4% All ages 14.7 100%

    Estimated annual age-specific incidence nation-wide, based on meta-analysis (using age-specific rates from Dong Thap province)

    * No cases in children < 2 years were found in Dong Thap, so incidence in this age group could not be estimated

    56% 77%

    Children < 15 years old are most at risk. Overall incidence of 5-14 year olds per year: 35.6 per 100,000

  • # provinces introduce Typhoid vaccine, 1997-2010 Year Province

    1997 8

    1998-1999 17

    2000 20

    2001 27

    2002 24

    2003 29

    2004 32

    2005 35

    2006 30

    2007 24

    2008 0

    2009 3

    2010 2

    1997: (8)

    2002:(24)

    2005: (35) 2007: (24)

    2010: (2)

  • Number of doses Typhoid vaccine use in EPI, 1997 - 2011 (x 1000)

  • Target population and coverage rate, 1997 - 2010

  • 0,07 0,09 0,12 0,26

    0,49 0,70

    0,47 0,40 0,51

    3,83

    0,00

    0,50

    1,00

    1,50

    2,00

    2,50

    3,00

    3,50

    4,00

    4,50

    U S

    $ Vaccine Price per Series to Vietnam

    EPI Program, 2010

  • Vaccines given and cases in Dien Bien province, 1998 - 2008

    0

    200

    400

    600

    800

    1000

    1200

    1400

    1600

    0

    5000

    10000

    15000

    20000

    25000

    30000

    1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

    N um

    be r o

    f c as

    es

    Va cc

    in e

    do se

    s gi

    ve n

    Vaccines given

    Cases identified

  • Vaccine coverage and Typhoid incidence (DOMI) -1

  • Vaccine coverage and Typhoid incidence (DOMI) - 2

  • Vaccine coverage and Typhoid incidence (DOMI) - 3

  • Vaccine coverage and Typhoid incidence (DOMI) - 4

  • Vaccine coverage and Typhoid incidence (DOMI) - 5

  • Vaccine coverage and Typhoid incidence (DOMI) - 6

  • Conclusions • Nationwide decrease in typhoid fever incidence in

    parallel with nationwide increase in vaccine coverage

    • Control of typhoid fever through immunization in high risk regions of the Northwest and Mekong River Delta prior of the other

    • Reduction in typhoid fever disease burden could also be attributed to other common preventive measures than just immunization

    • Long term and detail plan include surveillance need to be prepared

    • Support from international organization (technical and finance)

  • Thank you

    Typhoid Vaccine Used in Vietnam and its Impact Vietnam EPI vaccines in Vietnam Typhoid vaccine in EPI 1997 - 2010 Estimated Average Annual Incidence of Typhoid, 1999-2003 (DOMI program) Age Groups Slide Number 7 Number of doses Typhoid vaccine use in EPI, 1997 - 2011 (x 1000) Target population and coverage rate, 1997 - 2010 Slide Number 10 Vaccines given and cases in Dien Bien province, 1998 - 2008 Slide Number 12 Slide Number 13 Slide Number 14 Slide Number 15 Slide Number 16 Slide Number 17 Conclusions Thank you