World Health Organization• SEARO/FGL/IVD • 31 August 2016World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Immunization andVaccine Development
South-East Asia Region
Thailand 2016
Immunization system highlights
� There is a comprehensive multi-year plan (cMYP) for immunization covering 2013–2016.
� A standing national technical advisory group on immunization (NTAGI) fully functional.
� A national system to monitor adverse events following immunization (AEFI) exists.
� A national policy for health care waste management including waste from immunization activities exists.
� A national policy on seasonal influenza vaccination exists.
� 100% of all vaccine costs as well as routine immunization costs financed by the government.
� All 928 districts have updated micro-plans that include activities to raise immunization coverage.
� Rotavirus vaccine provided to 2 and 4 months children through a pilot project in Sukhothai Province.
� HPV vaccine provided to girl students of grade 5 and 6 through a pilot project in Pranakhonsri Ayuthaya Province.
� JE live attenuated vaccine started in 2013 in 8 provinces then expanded to cover 29 provinces in 2014 and will be expanded the whole country in 2016.
Source: WHO/UNICEF joint reporting form (JRF) 2015
Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
Table 1: Basic information1 2015Division/Province/State/Region 77
District 928
Sub-district 7 427
Village 74 948
Population density (per sq. km) 135
Population living in urban areas 48%
Population using improved drinking-water sources
96%
Population using improved sanitation 93%
Total expenditure on health as % of GDP 4.5%
Births attended by skilled health personnel 100%
Neonates protected at birth against NT 91%
Total population 65 729 098
Live births (LB) 675 530
Children <1 year 650 332
Children <5 years 3 676 952
Children <15 years 11 557 397
Pregnant women 675 530
Women of child bearing age (15–49 years)
17 284 706
Neonatal mortality rate2 3.5 (per 1 000 LB)
Infant mortality rate2 6.3 (per 1 000 LB)
Under-five mortality rate2 8.1 (per 1 000 LB)
Maternal mortality ratio2 23.3 (per 100 000 LB)
1 SEAR annual EPI reporting form (AERF) 2015 and WHO, World Health Statistics 2015 2 Bureau of policy and strategy, MOPH
Vaccine Age of administration
BCG At birth
HepB At birth, 1 month (new-born from HepB carrier mother)
DTP-HepB 2 months, 4 months, 6 months
OPV 2 months, 4 months, 6 months, 1.5 years, 4 years
MMR 9 Months, 2.5 years
DTP 1.5 years, 4 years
Td School children in grade VI (12 years) and pregnant women at 1st contact, +1 month, +6 months (depending on vaccination history)
JE_Inactd 1 years (2 doses 4 weeks apart), 2.5 years
JE_LiveAtd 1 years, 2.5 years (sub-national)
EPI history � EPI launched in 1977. � 1977 - BCG for newborns, DTP for infants at 2
and 4 months. � 1982 - OPV introduction, DTP 3rd dose for
infants at 6 months. � 1984 - MCV for 9–12 months infants. � 1986 - Rubella vaccine for 6th grade girls. � 1991 - DTP 4th dose for infants 1.5–2 years. � 1992 - HepB vaccine scaled up nation-wide. � 1993 - Rubella vaccine for 1st grade students. � 1996 - MCV for 1st grade students. � 1997 - MCV and rubella vaccine were
substituted by MMR for students. � 2000 - JE_Inactd vaccine introduced
countrywide. � 2000 - DTP 5th dose introduced for children
aged 4 years. � 2004 - Influenza vaccine introduced for HCWs. � 2008 - Influenza vaccine introduced for high
risk adults. � 2008 - DTP-HepB vaccine introduced. � 2010 - MCV vaccine substituted with MMR for
9–12 months infants. � IPV introduced in 2015. � Type 2 component of OPV withdrawn on 29
April 2016 by switching from tOPV to bOPV.
Table 2: Immunization schedule, 2015
Source: cMYP 2013–2016 and EPI/MOPH
Source: WHO/UNICEF joint reporting form (JRF) 2015
E P I F a c t S h E E t
Figure 12: Confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010–2015
Figure 10: Immunity against measles: Immunity profile by age in 2015*
Figure 13: Unimmunized confirmed (Lab and Epi linked)measles outbreak associated cases, by age, 2010–2015
Figure 14: Network of laboratories
Figure 11: Immunity against measles: Immunity profile by age in 2016*
*Modeled using MSP tool ver 2 based on coverage data up to 2015.
Source: SEAR annual EPI reporting form ND= No data
*Modeled using MSP tool ver 2 assuming the schedule and measles containing vaccine (MCV) coverage remain unchanged
Source: SEAR annual EPI reporting form ND = No data
Routine/sporadic cases Outbreak associated cases
Year No. of suspected
case
No. of death
No. of lab-confirmed
measles cases
No. of lab-confirmed
rubella cases
No. of suspected
outbreak
No. of Outbreak
Investigated
No. of case
No. of death
No. of measles
outbreak*
No. of confirmed
measles case*
No. of confirmed
rubella outbreak*
No. of confirmed
rubella cases*
2010 2 273 0 ND ND 0 0 0 0 ND ND ND
2011 3 056 0 67 13 12 11 269 0 9 22 0 1
2012 5 195 0 799 69 12 10 147 0 9 46 0 0
2013 2 633 0 271 42 8 8 59 0 7 39 0 0
2014 1 191 0 70 19 0 0 0 0 0 0 0 0
2015 588 0 57 36 7 23 60 0 9 9 2 35
Source: Monthly VPD Reporting to WHO/SEARO * Laboratory confirmed & epidemiologically- linked ND=No data
Table 8: Suspected sporadic and Outbreak associated measles and rubella cases, 2010–2015
Table 9: Quality of field and laboratory surveillance for measles and rubella, 2012–2015
Year
No. o
f Sus
pect
ed M
easl
es
Case classification (number) Indicators
Measles Rubella
Disc
arde
d no
n-m
easl
es n
on-
rube
lla c
ases
Annu
al in
cide
nce
of
confi
rmed
Mea
sles
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Annu
al in
cide
nce
of
confi
rmed
Rub
ella
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Prop
ortio
n of
all
susp
ecte
d m
easl
es a
nd ru
bella
cas
es
that
hav
e ha
d an
ade
quat
e in
vest
igat
ion
initi
ated
with
in
48 h
ours
of n
otifi
catio
n
Disc
arde
d no
n-m
easl
es
non-
rube
lla in
cide
nce
per
100
000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
natio
nal
adm
inis
trativ
e un
its re
porti
ng
at le
ast t
wo
disc
arde
d no
n-m
easl
es n
on-r
ubel
la c
ases
pe
r 100
000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
-nat
iona
l su
rvei
llanc
e un
its re
porti
ng
to th
e na
tiona
l lev
el o
n tim
e
Lab-
confi
rmed
Epi-L
inke
d
Clin
ical
ly-c
onfir
med
Lab-
confi
rmed
Epi-L
inke
d
Target – – 80% 2 80% 80%
2012 5 207 976 0 3 491 90 0 485 15.19 1.4 31.36 0.75 9.21 ND
2013 2 641 325 2 1 819 50 0 405 5.07 0.78 26.98 0.63 6.58 ND
2014 1 184 75 3 68 21 1 300 1.2 0.34 ND 0.46 3.95 ND
2015 1015 59 3 92 34 14 377 0.95 0.73 ND 0.58 9.21 ND
Source: SEAR Annual EPI Reporting Form ND=No data
Table 10: Performance of Laboratory Surveillance, 2012–2015
Year
% Serum specimen collected from
suspected measles cases
Total Serum Specimen received in Laboratory
% serum specimens
tested
Specimen Positive for Measles IgM
Specimen Positive for Rubella IgM
% Results within 4 of
receipt
% Outbreak tested for
viral detection
Genotypes detected
No. % No. % Measles Rubella
2012 ND ND ND ND ND ND ND ND ND ND ND
2013 ND ND ND ND ND ND ND ND ND ND ND
2014 37.5 416 100 75 18 21 5.1 92.1 100 B3 ND
2015 54.7 506 100 61 12.1 36 7.1 94.5 100 H1 2B
Source: SEAR Annual EPI Reporting Form ND=No data
For contact or feedback: Chief, Vaccine Preventable Disease Section Ministry of Public Health, Nonthaburi, Thailand Tel: +66-2-5903199, Fax + 66-2-9659152 Email: [email protected], www.moph.go.th
Immunization and Vaccine Development (IVD)WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, IndiaTel: +91 11 23370804, Fax: +91 11 23370251Email: [email protected], www.searo.who.int/entity/immunization
Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perc
ent o
f pop
ulat
ion
Age (in years)
Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perc
ent o
f pop
ulat
ion
Age (in years)
0
20
40
60
80
100
120
2010 2011 2012 2013 2014 2015
<1 year 1-4 years 5-9 years 10-14 years 15+ years
ND n=94 n=180 n=50 n=1 n=10
0
20
40
60
80
100
120
2010 2011 2012 2013 2014 2015
<1 year 1-4 years 5-9 years 10-14 years 15+ years
ND n=94 n=180 n=46 n=1 n=10 (100%) (100%) (92%) (100%) (100%)
National Institute of Health, Nonthaburi - Regional reference polio laboratory- Regional reference measles & rubella laboratory
Sub-national measles & rubella laboratories (13)
E P I F a c t S h E E t
World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Table 3: OPV supplementary immunization activities (SIA)
Figure 3: DTP-HepB3 coverage
Figure 5: Non-polio AFP rate by province, 2015Table 6: MCV supplementary immunization activities
Figure 7: MCV1 & MCV2 coverage1 and measles cases2, 1980–2015
Figure 9: Sporadic and outbreak associated measles cases* by month, 2010–2015
Figure 4: TT2+ coverage1 and NT cases2, 1980–2015
Figure 6: Adequate stool specimen collection percentage by province, 2015
Table 7: Districts with more than 95% MCV1 coverage
Figure 8: MCV1 coverage by district
Year Target (<5 years) children by round Dates by SIA round Coverage (%) by round
First Second First Second First Second
2000 5 320 365 5 350 859 21-Dec-00 18-Jan-01 >95 >95
2001 4 228 841 4 235 472 21-Dec-01 18-Jan-02 >95 >95
2002 3 253 754 3 259 466 18-Dec-02 21-Jan-03 >95 >95
2003 3 090 113 3 104 156 16-Dec-03 13-Jan-04 >95 >95
2004 3 202 447 3 085 319 21-Dec-04 18-Jan-05 >95 >95
2006 2 275 235 2 279 229 13-Dec-06 17-Jan-07 >95 >95
2007 2 385 009 2 385 460 26-Dec-07 23-Jan-08 >93 >93
2008 2 356 691 2 374 596 17-Dec-08 14-Jan-09 >95 >95
2009 2 465 626 2 481 614 23-Dec-09 27-Jan-10 >95 >95
2010 1 976 446 2 012 534 15-Dec-10 19-Jan-11 97 96
2011 1 173 775 1 181 487 14-Dec-11 18-Jan-12 94 >95
2012 951 795 819 037 14-Nov-12 12-Dec-12 95 95
2013 269 903 278 345 23-Jan-13 20-Feb-13 96 97
2014* 613 939 – Jan-2014 – 94 –
2015* 617 027 – Apr-2015 – 87 –
Source: NCCPE reports and WHO/UNICEF JRF* Thai children <5 yrs and foreign children (migrant) <15 yrs.
Indicator 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
AFP cases 305 225 261 212 272 249 289 235 238 183
Wild poliovirus confirmed cases 0 0 0 0 0 0 0 0 0 0
Compatible cases 0 0 0 0 0 0 0 0 0 0
AFP rate 2.26 1.67 1.95 1.65 2.08 1.90 2.21 1.80 1.97 1.52
Non-polio AFP rate1 2.26 1.67 1.95 1.64 2.08 1.90 2.21 1.80 1.97 1.36
Adequate stool specimen collection percentage2 81% 77% 79% 75% 70% 67% 74% 70% 79% 65%
Total stool samples collected 598 443 494 401 506 496 576 444 450 345
% NPEV isolation 5 3 5 3 5 6 5 5 5 3
% Timeliness of primary result reported3 100 99 100 98 100 100 100 100 100 100
Year Vaccine, geographic coverage, target group
Target Coverage Achieved
2002 M, sub-national, outbreak response & campaign
ND ND
2015 MR, nationwide, 2.5 to 7 years 2 541 544 88%
Year Number of districts %
2010 ND –
2011 ND –
2012 ND –
2013 ND –
2014 ND –
2015 ND –
1 Number of discarded AFP cases per 100,000 children under 15 years of age.2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset.3 2005 to 2007 result reported within 28 days and 2008 onwards result reported within 14 days of sample received at laboratory.
*Includes laboratory confirmed and epidemiologically linked casesSource: SEAR Monthly VPD reports
Source: WHO/UNICEF JRF
Source: WHO/UNICEF JRF
Table 4: AFP surveillance performance indicators, 2006–2015
• The last laboratory confirmed polio case due to wild polio virus (WPV) was reported in April 1997.
• Thailand achieved maternal and neonatal tetanus (MNT) elimination status in 1995.
Figure 1: National immunization coverage, 1980–2015 Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980–2015
Year Polio Diphtheria Pertussis Neonatal Tetanus (% of all Tetanus)
Measles Rubella Mumps Japanese Encephalitis
Congenital Rubella Syndrome
2006 0 2 72 3 (2%) 3 588 498 7 838 49 ND
2007 0 3 23 4 (3%) 3 893 341 9 299 43 ND
2008 0 8 16 3 (3%) 7 790 621 13 861 64 ND
2009 0 12 25 1 (1%) 6 071 594 20 383 36 ND
2010 0 77 6 3 (2%) 2 583 387 15 885 40 ND
2011 0 28 12 1 (1%) 3 156 517 10 077 52 ND
2012 0 63 14 4 (4%) 5 197 493 7 431 54 2
2013 0 28 24 2 (2%) 2 641 539 5 907 59 0
2014 0 19 14 2 (2%) 146 152 3 704 31 ND
2015 0 19 51 0 154 240 3 121 23 0
TableTable 5: Reported cases of vaccine preventable disease, 2006–2015
Source: WHO/UNICEF JRF ND=No data
Source: SEAR annual EPI reporting form
1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
1 Country official estimates, 1980–2015.2 WHO vaccine-preventable diseases: monitoring system 2016
Source: SEAR annual EPI reporting form
Source: WHO and UNICEF estimates of national immunization coverage, July 2016 revision
1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015BCG 68 80 99 98 99 99 99 99 99 99 99 99DTP3 49 62 92 96 97 98 99 99 99 99 99 99OPV3 19 61 92 96 97 98 99 99 99 99 99 99MCV1 26 80 91 94 96 98 98 98 99 99 99
0
20
40
60
80
100
% C
over
age
0
20
40
60
80
100
0
200
400
600
800
1000
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearDiphtheria Cases Pertussis Cases DTP3 Coverage
1918 4820 2533
2004 5,329 (99%) of 5386 sub-districts had >90% DTP3 coverage
2005–2015 Sub-national immunization coverage data not available.
0
20
40
60
80
100
0
100
200
300
400
500
600
700
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearNT cases TT2+ coverage
<1 1–1.99 > No non-polio AFP case2 <60% 60%–79% > No AFP80
0
20
40
60
80
100
0
2000
4000
6000
8000
10000
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearMeasles Cases MCV1 Coverage MCV2 Coverage
16795 32156 29244 11112
2004 5 299 (98%) of 5386 sub-districts had >90% MCV1 coverage
2005–2015 Sub-national immunization coverage data not available.
0
20
40
60
80
100
120
Jan-
10
Mar-1
0
May-1
0
Jul-1
0
Sep-
10
Nov-1
0
Jan-
11
Mar-1
1
May-1
1
Jul-1
1
Sep-
11
Nov-1
1
Jan-
12
Mar-1
2
May-1
2
Jul-1
2
Sep-
12
Nov-1
2
Jan-
13
Mar-1
3
May-1
3
Jul-1
3
Sep-
13
Nov-1
3
Jan-
14
Mar-1
4
May-1
4
Jul-1
4
Sep-
14
Nov-1
4
Jan-
15
Mar-1
5
May-1
5
Jul-1
5
Sep-
15
Nov-1
5
No. o
f cas
es
Sporadic measles Outbreak associated measles
E P I F a c t S h E E t
World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Table 3: OPV supplementary immunization activities (SIA)
Figure 3: DTP-HepB3 coverage
Figure 5: Non-polio AFP rate by province, 2015Table 6: MCV supplementary immunization activities
Figure 7: MCV1 & MCV2 coverage1 and measles cases2, 1980–2015
Figure 9: Sporadic and outbreak associated measles cases* by month, 2010–2015
Figure 4: TT2+ coverage1 and NT cases2, 1980–2015
Figure 6: Adequate stool specimen collection percentage by province, 2015
Table 7: Districts with more than 95% MCV1 coverage
Figure 8: MCV1 coverage by district
Year Target (<5 years) children by round Dates by SIA round Coverage (%) by round
First Second First Second First Second
2000 5 320 365 5 350 859 21-Dec-00 18-Jan-01 >95 >95
2001 4 228 841 4 235 472 21-Dec-01 18-Jan-02 >95 >95
2002 3 253 754 3 259 466 18-Dec-02 21-Jan-03 >95 >95
2003 3 090 113 3 104 156 16-Dec-03 13-Jan-04 >95 >95
2004 3 202 447 3 085 319 21-Dec-04 18-Jan-05 >95 >95
2006 2 275 235 2 279 229 13-Dec-06 17-Jan-07 >95 >95
2007 2 385 009 2 385 460 26-Dec-07 23-Jan-08 >93 >93
2008 2 356 691 2 374 596 17-Dec-08 14-Jan-09 >95 >95
2009 2 465 626 2 481 614 23-Dec-09 27-Jan-10 >95 >95
2010 1 976 446 2 012 534 15-Dec-10 19-Jan-11 97 96
2011 1 173 775 1 181 487 14-Dec-11 18-Jan-12 94 >95
2012 951 795 819 037 14-Nov-12 12-Dec-12 95 95
2013 269 903 278 345 23-Jan-13 20-Feb-13 96 97
2014* 613 939 – Jan-2014 – 94 –
2015* 617 027 – Apr-2015 – 87 –
Source: NCCPE reports and WHO/UNICEF JRF* Thai children <5 yrs and foreign children (migrant) <15 yrs.
Indicator 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
AFP cases 305 225 261 212 272 249 289 235 238 183
Wild poliovirus confirmed cases 0 0 0 0 0 0 0 0 0 0
Compatible cases 0 0 0 0 0 0 0 0 0 0
AFP rate 2.26 1.67 1.95 1.65 2.08 1.90 2.21 1.80 1.97 1.52
Non-polio AFP rate1 2.26 1.67 1.95 1.64 2.08 1.90 2.21 1.80 1.97 1.36
Adequate stool specimen collection percentage2 81% 77% 79% 75% 70% 67% 74% 70% 79% 65%
Total stool samples collected 598 443 494 401 506 496 576 444 450 345
% NPEV isolation 5 3 5 3 5 6 5 5 5 3
% Timeliness of primary result reported3 100 99 100 98 100 100 100 100 100 100
Year Vaccine, geographic coverage, target group
Target Coverage Achieved
2002 M, sub-national, outbreak response & campaign
ND ND
2015 MR, nationwide, 2.5 to 7 years 2 541 544 88%
Year Number of districts %
2010 ND –
2011 ND –
2012 ND –
2013 ND –
2014 ND –
2015 ND –
1 Number of discarded AFP cases per 100,000 children under 15 years of age.2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset.3 2005 to 2007 result reported within 28 days and 2008 onwards result reported within 14 days of sample received at laboratory.
*Includes laboratory confirmed and epidemiologically linked casesSource: SEAR Monthly VPD reports
Source: WHO/UNICEF JRF
Source: WHO/UNICEF JRF
Table 4: AFP surveillance performance indicators, 2006–2015
• The last laboratory confirmed polio case due to wild polio virus (WPV) was reported in April 1997.
• Thailand achieved maternal and neonatal tetanus (MNT) elimination status in 1995.
Figure 1: National immunization coverage, 1980–2015 Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980–2015
Year Polio Diphtheria Pertussis Neonatal Tetanus (% of all Tetanus)
Measles Rubella Mumps Japanese Encephalitis
Congenital Rubella Syndrome
2006 0 2 72 3 (2%) 3 588 498 7 838 49 ND
2007 0 3 23 4 (3%) 3 893 341 9 299 43 ND
2008 0 8 16 3 (3%) 7 790 621 13 861 64 ND
2009 0 12 25 1 (1%) 6 071 594 20 383 36 ND
2010 0 77 6 3 (2%) 2 583 387 15 885 40 ND
2011 0 28 12 1 (1%) 3 156 517 10 077 52 ND
2012 0 63 14 4 (4%) 5 197 493 7 431 54 2
2013 0 28 24 2 (2%) 2 641 539 5 907 59 0
2014 0 19 14 2 (2%) 146 152 3 704 31 ND
2015 0 19 51 0 154 240 3 121 23 0
TableTable 5: Reported cases of vaccine preventable disease, 2006–2015
Source: WHO/UNICEF JRF ND=No data
Source: SEAR annual EPI reporting form
1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
1 Country official estimates, 1980–2015.2 WHO vaccine-preventable diseases: monitoring system 2016
Source: SEAR annual EPI reporting form
Source: WHO and UNICEF estimates of national immunization coverage, July 2016 revision
1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015BCG 68 80 99 98 99 99 99 99 99 99 99 99DTP3 49 62 92 96 97 98 99 99 99 99 99 99OPV3 19 61 92 96 97 98 99 99 99 99 99 99MCV1 26 80 91 94 96 98 98 98 99 99 99
0
20
40
60
80
100
% C
over
age
0
20
40
60
80
100
0
200
400
600
800
1000
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearDiphtheria Cases Pertussis Cases DTP3 Coverage
1918 4820 2533
2004 5,329 (99%) of 5386 sub-districts had >90% DTP3 coverage
2005–2015 Sub-national immunization coverage data not available.
0
20
40
60
80
100
0
100
200
300
400
500
600
700
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearNT cases TT2+ coverage
<1 1–1.99 > No non-polio AFP case2 <60% 60%–79% > No AFP80
0
20
40
60
80
100
0
2000
4000
6000
8000
10000
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearMeasles Cases MCV1 Coverage MCV2 Coverage
16795 32156 29244 11112
2004 5 299 (98%) of 5386 sub-districts had >90% MCV1 coverage
2005–2015 Sub-national immunization coverage data not available.
0
20
40
60
80
100
120
Jan-
10
Mar-1
0
May-1
0
Jul-1
0
Sep-
10
Nov-1
0
Jan-
11
Mar-1
1
May-1
1
Jul-1
1
Sep-
11
Nov-1
1
Jan-
12
Mar-1
2
May-1
2
Jul-1
2
Sep-
12
Nov-1
2
Jan-
13
Mar-1
3
May-1
3
Jul-1
3
Sep-
13
Nov-1
3
Jan-
14
Mar-1
4
May-1
4
Jul-1
4
Sep-
14
Nov-1
4
Jan-
15
Mar-1
5
May-1
5
Jul-1
5
Sep-
15
Nov-1
5
No. o
f cas
es
Sporadic measles Outbreak associated measles
E P I F a c t S h E E t
World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Table 3: OPV supplementary immunization activities (SIA)
Figure 3: DTP-HepB3 coverage
Figure 5: Non-polio AFP rate by province, 2015Table 6: MCV supplementary immunization activities
Figure 7: MCV1 & MCV2 coverage1 and measles cases2, 1980–2015
Figure 9: Sporadic and outbreak associated measles cases* by month, 2010–2015
Figure 4: TT2+ coverage1 and NT cases2, 1980–2015
Figure 6: Adequate stool specimen collection percentage by province, 2015
Table 7: Districts with more than 95% MCV1 coverage
Figure 8: MCV1 coverage by district
Year Target (<5 years) children by round Dates by SIA round Coverage (%) by round
First Second First Second First Second
2000 5 320 365 5 350 859 21-Dec-00 18-Jan-01 >95 >95
2001 4 228 841 4 235 472 21-Dec-01 18-Jan-02 >95 >95
2002 3 253 754 3 259 466 18-Dec-02 21-Jan-03 >95 >95
2003 3 090 113 3 104 156 16-Dec-03 13-Jan-04 >95 >95
2004 3 202 447 3 085 319 21-Dec-04 18-Jan-05 >95 >95
2006 2 275 235 2 279 229 13-Dec-06 17-Jan-07 >95 >95
2007 2 385 009 2 385 460 26-Dec-07 23-Jan-08 >93 >93
2008 2 356 691 2 374 596 17-Dec-08 14-Jan-09 >95 >95
2009 2 465 626 2 481 614 23-Dec-09 27-Jan-10 >95 >95
2010 1 976 446 2 012 534 15-Dec-10 19-Jan-11 97 96
2011 1 173 775 1 181 487 14-Dec-11 18-Jan-12 94 >95
2012 951 795 819 037 14-Nov-12 12-Dec-12 95 95
2013 269 903 278 345 23-Jan-13 20-Feb-13 96 97
2014* 613 939 – Jan-2014 – 94 –
2015* 617 027 – Apr-2015 – 87 –
Source: NCCPE reports and WHO/UNICEF JRF* Thai children <5 yrs and foreign children (migrant) <15 yrs.
Indicator 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
AFP cases 305 225 261 212 272 249 289 235 238 183
Wild poliovirus confirmed cases 0 0 0 0 0 0 0 0 0 0
Compatible cases 0 0 0 0 0 0 0 0 0 0
AFP rate 2.26 1.67 1.95 1.65 2.08 1.90 2.21 1.80 1.97 1.52
Non-polio AFP rate1 2.26 1.67 1.95 1.64 2.08 1.90 2.21 1.80 1.97 1.36
Adequate stool specimen collection percentage2 81% 77% 79% 75% 70% 67% 74% 70% 79% 65%
Total stool samples collected 598 443 494 401 506 496 576 444 450 345
% NPEV isolation 5 3 5 3 5 6 5 5 5 3
% Timeliness of primary result reported3 100 99 100 98 100 100 100 100 100 100
Year Vaccine, geographic coverage, target group
Target Coverage Achieved
2002 M, sub-national, outbreak response & campaign
ND ND
2015 MR, nationwide, 2.5 to 7 years 2 541 544 88%
Year Number of districts %
2010 ND –
2011 ND –
2012 ND –
2013 ND –
2014 ND –
2015 ND –
1 Number of discarded AFP cases per 100,000 children under 15 years of age.2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset.3 2005 to 2007 result reported within 28 days and 2008 onwards result reported within 14 days of sample received at laboratory.
*Includes laboratory confirmed and epidemiologically linked casesSource: SEAR Monthly VPD reports
Source: WHO/UNICEF JRF
Source: WHO/UNICEF JRF
Table 4: AFP surveillance performance indicators, 2006–2015
• The last laboratory confirmed polio case due to wild polio virus (WPV) was reported in April 1997.
• Thailand achieved maternal and neonatal tetanus (MNT) elimination status in 1995.
Figure 1: National immunization coverage, 1980–2015 Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980–2015
Year Polio Diphtheria Pertussis Neonatal Tetanus (% of all Tetanus)
Measles Rubella Mumps Japanese Encephalitis
Congenital Rubella Syndrome
2006 0 2 72 3 (2%) 3 588 498 7 838 49 ND
2007 0 3 23 4 (3%) 3 893 341 9 299 43 ND
2008 0 8 16 3 (3%) 7 790 621 13 861 64 ND
2009 0 12 25 1 (1%) 6 071 594 20 383 36 ND
2010 0 77 6 3 (2%) 2 583 387 15 885 40 ND
2011 0 28 12 1 (1%) 3 156 517 10 077 52 ND
2012 0 63 14 4 (4%) 5 197 493 7 431 54 2
2013 0 28 24 2 (2%) 2 641 539 5 907 59 0
2014 0 19 14 2 (2%) 146 152 3 704 31 ND
2015 0 19 51 0 154 240 3 121 23 0
TableTable 5: Reported cases of vaccine preventable disease, 2006–2015
Source: WHO/UNICEF JRF ND=No data
Source: SEAR annual EPI reporting form
1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
1 Country official estimates, 1980–2015.2 WHO vaccine-preventable diseases: monitoring system 2016
Source: SEAR annual EPI reporting form
Source: WHO and UNICEF estimates of national immunization coverage, July 2016 revision
1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015BCG 68 80 99 98 99 99 99 99 99 99 99 99DTP3 49 62 92 96 97 98 99 99 99 99 99 99OPV3 19 61 92 96 97 98 99 99 99 99 99 99MCV1 26 80 91 94 96 98 98 98 99 99 99
0
20
40
60
80
100
% C
over
age
0
20
40
60
80
100
0
200
400
600
800
1000
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearDiphtheria Cases Pertussis Cases DTP3 Coverage
1918 4820 2533
2004 5,329 (99%) of 5386 sub-districts had >90% DTP3 coverage
2005–2015 Sub-national immunization coverage data not available.
0
20
40
60
80
100
0
100
200
300
400
500
600
700
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearNT cases TT2+ coverage
<1 1–1.99 > No non-polio AFP case2 <60% 60%–79% > No AFP80
0
20
40
60
80
100
0
2000
4000
6000
8000
10000
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearMeasles Cases MCV1 Coverage MCV2 Coverage
16795 32156 29244 11112
2004 5 299 (98%) of 5386 sub-districts had >90% MCV1 coverage
2005–2015 Sub-national immunization coverage data not available.
0
20
40
60
80
100
120
Jan-
10
Mar-1
0
May-1
0
Jul-1
0
Sep-
10
Nov-1
0
Jan-
11
Mar-1
1
May-1
1
Jul-1
1
Sep-
11
Nov-1
1
Jan-
12
Mar-1
2
May-1
2
Jul-1
2
Sep-
12
Nov-1
2
Jan-
13
Mar-1
3
May-1
3
Jul-1
3
Sep-
13
Nov-1
3
Jan-
14
Mar-1
4
May-1
4
Jul-1
4
Sep-
14
Nov-1
4
Jan-
15
Mar-1
5
May-1
5
Jul-1
5
Sep-
15
Nov-1
5
No. o
f cas
es
Sporadic measles Outbreak associated measles
World Health Organization• SEARO/FGL/IVD • 31 August 2016World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Immunization andVaccine Development
South-East Asia Region
Thailand 2016
Immunization system highlights
� There is a comprehensive multi-year plan (cMYP) for immunization covering 2013–2016.
� A standing national technical advisory group on immunization (NTAGI) fully functional.
� A national system to monitor adverse events following immunization (AEFI) exists.
� A national policy for health care waste management including waste from immunization activities exists.
� A national policy on seasonal influenza vaccination exists.
� 100% of all vaccine costs as well as routine immunization costs financed by the government.
� All 928 districts have updated micro-plans that include activities to raise immunization coverage.
� Rotavirus vaccine provided to 2 and 4 months children through a pilot project in Sukhothai Province.
� HPV vaccine provided to girl students of grade 5 and 6 through a pilot project in Pranakhonsri Ayuthaya Province.
� JE live attenuated vaccine started in 2013 in 8 provinces then expanded to cover 29 provinces in 2014 and will be expanded the whole country in 2016.
Source: WHO/UNICEF joint reporting form (JRF) 2015
Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
Table 1: Basic information1 2015Division/Province/State/Region 77
District 928
Sub-district 7 427
Village 74 948
Population density (per sq. km) 135
Population living in urban areas 48%
Population using improved drinking-water sources
96%
Population using improved sanitation 93%
Total expenditure on health as % of GDP 4.5%
Births attended by skilled health personnel 100%
Neonates protected at birth against NT 91%
Total population 65 729 098
Live births (LB) 675 530
Children <1 year 650 332
Children <5 years 3 676 952
Children <15 years 11 557 397
Pregnant women 675 530
Women of child bearing age (15–49 years)
17 284 706
Neonatal mortality rate2 3.5 (per 1 000 LB)
Infant mortality rate2 6.3 (per 1 000 LB)
Under-five mortality rate2 8.1 (per 1 000 LB)
Maternal mortality ratio2 23.3 (per 100 000 LB)
1 SEAR annual EPI reporting form (AERF) 2015 and WHO, World Health Statistics 2015 2 Bureau of policy and strategy, MOPH
Vaccine Age of administration
BCG At birth
HepB At birth, 1 month (new-born from HepB carrier mother)
DTP-HepB 2 months, 4 months, 6 months
OPV 2 months, 4 months, 6 months, 1.5 years, 4 years
MMR 9 Months, 2.5 years
DTP 1.5 years, 4 years
Td School children in grade VI (12 years) and pregnant women at 1st contact, +1 month, +6 months (depending on vaccination history)
JE_Inactd 1 years (2 doses 4 weeks apart), 2.5 years
JE_LiveAtd 1 years, 2.5 years (sub-national)
EPI history � EPI launched in 1977. � 1977 - BCG for newborns, DTP for infants at 2
and 4 months. � 1982 - OPV introduction, DTP 3rd dose for
infants at 6 months. � 1984 - MCV for 9–12 months infants. � 1986 - Rubella vaccine for 6th grade girls. � 1991 - DTP 4th dose for infants 1.5–2 years. � 1992 - HepB vaccine scaled up nation-wide. � 1993 - Rubella vaccine for 1st grade students. � 1996 - MCV for 1st grade students. � 1997 - MCV and rubella vaccine were
substituted by MMR for students. � 2000 - JE_Inactd vaccine introduced
countrywide. � 2000 - DTP 5th dose introduced for children
aged 4 years. � 2004 - Influenza vaccine introduced for HCWs. � 2008 - Influenza vaccine introduced for high
risk adults. � 2008 - DTP-HepB vaccine introduced. � 2010 - MCV vaccine substituted with MMR for
9–12 months infants. � IPV introduced in 2015. � Type 2 component of OPV withdrawn on 29
April 2016 by switching from tOPV to bOPV.
Table 2: Immunization schedule, 2015
Source: cMYP 2013–2016 and EPI/MOPH
Source: WHO/UNICEF joint reporting form (JRF) 2015
E P I F a c t S h E E t
Figure 12: Confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010–2015
Figure 10: Immunity against measles: Immunity profile by age in 2015*
Figure 13: Unimmunized confirmed (Lab and Epi linked)measles outbreak associated cases, by age, 2010–2015
Figure 14: Network of laboratories
Figure 11: Immunity against measles: Immunity profile by age in 2016*
*Modeled using MSP tool ver 2 based on coverage data up to 2015.
Source: SEAR annual EPI reporting form ND= No data
*Modeled using MSP tool ver 2 assuming the schedule and measles containing vaccine (MCV) coverage remain unchanged
Source: SEAR annual EPI reporting form ND = No data
Routine/sporadic cases Outbreak associated cases
Year No. of suspected
case
No. of death
No. of lab-confirmed
measles cases
No. of lab-confirmed
rubella cases
No. of suspected
outbreak
No. of Outbreak
Investigated
No. of case
No. of death
No. of measles
outbreak*
No. of confirmed
measles case*
No. of confirmed
rubella outbreak*
No. of confirmed
rubella cases*
2010 2 273 0 ND ND 0 0 0 0 ND ND ND
2011 3 056 0 67 13 12 11 269 0 9 22 0 1
2012 5 195 0 799 69 12 10 147 0 9 46 0 0
2013 2 633 0 271 42 8 8 59 0 7 39 0 0
2014 1 191 0 70 19 0 0 0 0 0 0 0 0
2015 588 0 57 36 7 23 60 0 9 9 2 35
Source: Monthly VPD Reporting to WHO/SEARO * Laboratory confirmed & epidemiologically- linked ND=No data
Table 8: Suspected sporadic and Outbreak associated measles and rubella cases, 2010–2015
Table 9: Quality of field and laboratory surveillance for measles and rubella, 2012–2015
Year
No. o
f Sus
pect
ed M
easl
es
Case classification (number) Indicators
Measles Rubella
Disc
arde
d no
n-m
easl
es n
on-
rube
lla c
ases
Annu
al in
cide
nce
of
confi
rmed
Mea
sles
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Annu
al in
cide
nce
of
confi
rmed
Rub
ella
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Prop
ortio
n of
all
susp
ecte
d m
easl
es a
nd ru
bella
cas
es
that
hav
e ha
d an
ade
quat
e in
vest
igat
ion
initi
ated
with
in
48 h
ours
of n
otifi
catio
n
Disc
arde
d no
n-m
easl
es
non-
rube
lla in
cide
nce
per
100
000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
natio
nal
adm
inis
trativ
e un
its re
porti
ng
at le
ast t
wo
disc
arde
d no
n-m
easl
es n
on-r
ubel
la c
ases
pe
r 100
000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
-nat
iona
l su
rvei
llanc
e un
its re
porti
ng
to th
e na
tiona
l lev
el o
n tim
e
Lab-
confi
rmed
Epi-L
inke
d
Clin
ical
ly-c
onfir
med
Lab-
confi
rmed
Epi-L
inke
d
Target – – 80% 2 80% 80%
2012 5 207 976 0 3 491 90 0 485 15.19 1.4 31.36 0.75 9.21 ND
2013 2 641 325 2 1 819 50 0 405 5.07 0.78 26.98 0.63 6.58 ND
2014 1 184 75 3 68 21 1 300 1.2 0.34 ND 0.46 3.95 ND
2015 1015 59 3 92 34 14 377 0.95 0.73 ND 0.58 9.21 ND
Source: SEAR Annual EPI Reporting Form ND=No data
Table 10: Performance of Laboratory Surveillance, 2012–2015
Year
% Serum specimen collected from
suspected measles cases
Total Serum Specimen received in Laboratory
% serum specimens
tested
Specimen Positive for Measles IgM
Specimen Positive for Rubella IgM
% Results within 4 of
receipt
% Outbreak tested for
viral detection
Genotypes detected
No. % No. % Measles Rubella
2012 ND ND ND ND ND ND ND ND ND ND ND
2013 ND ND ND ND ND ND ND ND ND ND ND
2014 37.5 416 100 75 18 21 5.1 92.1 100 B3 ND
2015 54.7 506 100 61 12.1 36 7.1 94.5 100 H1 2B
Source: SEAR Annual EPI Reporting Form ND=No data
For contact or feedback: Chief, Vaccine Preventable Disease Section Ministry of Public Health, Nonthaburi, Thailand Tel: +66-2-5903199, Fax + 66-2-9659152 Email: [email protected], www.moph.go.th
Immunization and Vaccine Development (IVD)WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, IndiaTel: +91 11 23370804, Fax: +91 11 23370251Email: [email protected], www.searo.who.int/entity/immunization
Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perc
ent o
f pop
ulat
ion
Age (in years)
Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perc
ent o
f pop
ulat
ion
Age (in years)
0
20
40
60
80
100
120
2010 2011 2012 2013 2014 2015
<1 year 1-4 years 5-9 years 10-14 years 15+ years
ND n=94 n=180 n=50 n=1 n=10
0
20
40
60
80
100
120
2010 2011 2012 2013 2014 2015
<1 year 1-4 years 5-9 years 10-14 years 15+ years
ND n=94 n=180 n=46 n=1 n=10 (100%) (100%) (92%) (100%) (100%)
National Institute of Health, Nonthaburi - Regional reference polio laboratory- Regional reference measles & rubella laboratory
Sub-national measles & rubella laboratories (13)
World Health Organization• SEARO/FGL/IVD • 31 August 2016World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Immunization andVaccine Development
South-East Asia Region
Thailand 2016
Immunization system highlights
� There is a comprehensive multi-year plan (cMYP) for immunization covering 2013–2016.
� A standing national technical advisory group on immunization (NTAGI) fully functional.
� A national system to monitor adverse events following immunization (AEFI) exists.
� A national policy for health care waste management including waste from immunization activities exists.
� A national policy on seasonal influenza vaccination exists.
� 100% of all vaccine costs as well as routine immunization costs financed by the government.
� All 928 districts have updated micro-plans that include activities to raise immunization coverage.
� Rotavirus vaccine provided to 2 and 4 months children through a pilot project in Sukhothai Province.
� HPV vaccine provided to girl students of grade 5 and 6 through a pilot project in Pranakhonsri Ayuthaya Province.
� JE live attenuated vaccine started in 2013 in 8 provinces then expanded to cover 29 provinces in 2014 and will be expanded the whole country in 2016.
Source: WHO/UNICEF joint reporting form (JRF) 2015
Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
Table 1: Basic information1 2015Division/Province/State/Region 77
District 928
Sub-district 7 427
Village 74 948
Population density (per sq. km) 135
Population living in urban areas 48%
Population using improved drinking-water sources
96%
Population using improved sanitation 93%
Total expenditure on health as % of GDP 4.5%
Births attended by skilled health personnel 100%
Neonates protected at birth against NT 91%
Total population 65 729 098
Live births (LB) 675 530
Children <1 year 650 332
Children <5 years 3 676 952
Children <15 years 11 557 397
Pregnant women 675 530
Women of child bearing age (15–49 years)
17 284 706
Neonatal mortality rate2 3.5 (per 1 000 LB)
Infant mortality rate2 6.3 (per 1 000 LB)
Under-five mortality rate2 8.1 (per 1 000 LB)
Maternal mortality ratio2 23.3 (per 100 000 LB)
1 SEAR annual EPI reporting form (AERF) 2015 and WHO, World Health Statistics 2015 2 Bureau of policy and strategy, MOPH
Vaccine Age of administration
BCG At birth
HepB At birth, 1 month (new-born from HepB carrier mother)
DTP-HepB 2 months, 4 months, 6 months
OPV 2 months, 4 months, 6 months, 1.5 years, 4 years
MMR 9 Months, 2.5 years
DTP 1.5 years, 4 years
Td School children in grade VI (12 years) and pregnant women at 1st contact, +1 month, +6 months (depending on vaccination history)
JE_Inactd 1 years (2 doses 4 weeks apart), 2.5 years
JE_LiveAtd 1 years, 2.5 years (sub-national)
EPI history � EPI launched in 1977. � 1977 - BCG for newborns, DTP for infants at 2
and 4 months. � 1982 - OPV introduction, DTP 3rd dose for
infants at 6 months. � 1984 - MCV for 9–12 months infants. � 1986 - Rubella vaccine for 6th grade girls. � 1991 - DTP 4th dose for infants 1.5–2 years. � 1992 - HepB vaccine scaled up nation-wide. � 1993 - Rubella vaccine for 1st grade students. � 1996 - MCV for 1st grade students. � 1997 - MCV and rubella vaccine were
substituted by MMR for students. � 2000 - JE_Inactd vaccine introduced
countrywide. � 2000 - DTP 5th dose introduced for children
aged 4 years. � 2004 - Influenza vaccine introduced for HCWs. � 2008 - Influenza vaccine introduced for high
risk adults. � 2008 - DTP-HepB vaccine introduced. � 2010 - MCV vaccine substituted with MMR for
9–12 months infants. � IPV introduced in 2015. � Type 2 component of OPV withdrawn on 29
April 2016 by switching from tOPV to bOPV.
Table 2: Immunization schedule, 2015
Source: cMYP 2013–2016 and EPI/MOPH
Source: WHO/UNICEF joint reporting form (JRF) 2015
E P I F a c t S h E E t
Figure 12: Confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010–2015
Figure 10: Immunity against measles: Immunity profile by age in 2015*
Figure 13: Unimmunized confirmed (Lab and Epi linked)measles outbreak associated cases, by age, 2010–2015
Figure 14: Network of laboratories
Figure 11: Immunity against measles: Immunity profile by age in 2016*
*Modeled using MSP tool ver 2 based on coverage data up to 2015.
Source: SEAR annual EPI reporting form ND= No data
*Modeled using MSP tool ver 2 assuming the schedule and measles containing vaccine (MCV) coverage remain unchanged
Source: SEAR annual EPI reporting form ND = No data
Routine/sporadic cases Outbreak associated cases
Year No. of suspected
case
No. of death
No. of lab-confirmed
measles cases
No. of lab-confirmed
rubella cases
No. of suspected
outbreak
No. of Outbreak
Investigated
No. of case
No. of death
No. of measles
outbreak*
No. of confirmed
measles case*
No. of confirmed
rubella outbreak*
No. of confirmed
rubella cases*
2010 2 273 0 ND ND 0 0 0 0 ND ND ND
2011 3 056 0 67 13 12 11 269 0 9 22 0 1
2012 5 195 0 799 69 12 10 147 0 9 46 0 0
2013 2 633 0 271 42 8 8 59 0 7 39 0 0
2014 1 191 0 70 19 0 0 0 0 0 0 0 0
2015 588 0 57 36 7 23 60 0 9 9 2 35
Source: Monthly VPD Reporting to WHO/SEARO * Laboratory confirmed & epidemiologically- linked ND=No data
Table 8: Suspected sporadic and Outbreak associated measles and rubella cases, 2010–2015
Table 9: Quality of field and laboratory surveillance for measles and rubella, 2012–2015
Year
No. o
f Sus
pect
ed M
easl
es
Case classification (number) Indicators
Measles Rubella
Disc
arde
d no
n-m
easl
es n
on-
rube
lla c
ases
Annu
al in
cide
nce
of
confi
rmed
Mea
sles
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Annu
al in
cide
nce
of
confi
rmed
Rub
ella
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Prop
ortio
n of
all
susp
ecte
d m
easl
es a
nd ru
bella
cas
es
that
hav
e ha
d an
ade
quat
e in
vest
igat
ion
initi
ated
with
in
48 h
ours
of n
otifi
catio
n
Disc
arde
d no
n-m
easl
es
non-
rube
lla in
cide
nce
per
100
000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
natio
nal
adm
inis
trativ
e un
its re
porti
ng
at le
ast t
wo
disc
arde
d no
n-m
easl
es n
on-r
ubel
la c
ases
pe
r 100
000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
-nat
iona
l su
rvei
llanc
e un
its re
porti
ng
to th
e na
tiona
l lev
el o
n tim
e
Lab-
confi
rmed
Epi-L
inke
d
Clin
ical
ly-c
onfir
med
Lab-
confi
rmed
Epi-L
inke
dTarget – – 80% 2 80% 80%
2012 5 207 976 0 3 491 90 0 485 15.19 1.4 31.36 0.75 9.21 ND
2013 2 641 325 2 1 819 50 0 405 5.07 0.78 26.98 0.63 6.58 ND
2014 1 184 75 3 68 21 1 300 1.2 0.34 ND 0.46 3.95 ND
2015 1015 59 3 92 34 14 377 0.95 0.73 ND 0.58 9.21 ND
Source: SEAR Annual EPI Reporting Form ND=No data
Table 10: Performance of Laboratory Surveillance, 2012–2015
Year
% Serum specimen collected from
suspected measles cases
Total Serum Specimen received in Laboratory
% serum specimens
tested
Specimen Positive for Measles IgM
Specimen Positive for Rubella IgM
% Results within 4 of
receipt
% Outbreak tested for
viral detection
Genotypes detected
No. % No. % Measles Rubella
2012 ND ND ND ND ND ND ND ND ND ND ND
2013 ND ND ND ND ND ND ND ND ND ND ND
2014 37.5 416 100 75 18 21 5.1 92.1 100 B3 ND
2015 54.7 506 100 61 12.1 36 7.1 94.5 100 H1 2B
Source: SEAR Annual EPI Reporting Form ND=No data
For contact or feedback: Chief, Vaccine Preventable Disease Section Ministry of Public Health, Nonthaburi, Thailand Tel: +66-2-5903199, Fax + 66-2-9659152 Email: [email protected], www.moph.go.th
Immunization and Vaccine Development (IVD)WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, IndiaTel: +91 11 23370804, Fax: +91 11 23370251Email: [email protected], www.searo.who.int/entity/immunization
Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perc
ent o
f pop
ulat
ion
Age (in years)
Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perc
ent o
f pop
ulat
ion
Age (in years)
0
20
40
60
80
100
120
2010 2011 2012 2013 2014 2015
<1 year 1-4 years 5-9 years 10-14 years 15+ years
ND n=94 n=180 n=50 n=1 n=10
0
20
40
60
80
100
120
2010 2011 2012 2013 2014 2015
<1 year 1-4 years 5-9 years 10-14 years 15+ years
ND n=94 n=180 n=46 n=1 n=10 (100%) (100%) (92%) (100%) (100%)
National Institute of Health, Nonthaburi - Regional reference polio laboratory- Regional reference measles & rubella laboratory
Sub-national measles & rubella laboratories (13)
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