World Health Organization, South-East Asia Regional Office
Thailand 2017
Expanded Programme on Immunization (EPI)
FACT SHEET
Acronyms
AD
Auto disable
MCV1
First dose measles containing vaccine
AEFI
Adverse events following immunization
MCV2
Second dose measles containing vaccine
AFP
Acute flaccid paralysis
MICS
Multiple indicator cluster survey
BCG
Bacillus Calmette-Guérin vaccine
MMR
Measles mumps rubella vaccine
CES
Coverage evaluation survey
MNT
Maternal and neonatal tetanus
cMYP
Comprehensive multi-year plan
MR
Measles rubella vaccine
CRS
Congenital rubella syndrome
NCIP
National committee on immunization practices
DHS
Demographic health survey
NID
National immunization day
DT
Diphtheria tetanus toxoid, pediatric
NTAGI
National technical advisory group on immunization
DTP
Diphtheria – tetanus – pertussis vaccine
NPEV
Non-polio enterovirus
DTP-Hib-HepB
Pentavalent vaccine
NT
Neonatal tetanus
DTP-Hib-HepB3 3rd dose pentavalent vaccine
OPV
Oral poliovirus vaccine
EPI
Expanded programme on immunization
bOPV
Bivalent OPV
GDP
Gross domestic product
tOPV
Trivalent OPV
HCW
Health care worker
PCV
Pneumococcal conjugate vaccine
HepB
Hepatitis B vaccine
SEAR
WHO South-East Asia Region
Hib
Haemophilus influenzae type b
SIA
Supplementary immunization activities
HPV
Human papilloma virus
SNID
Subnational immunization day
IgM
Immunoglobulin M
Td
Tetanus diphtheria toxoid; older children, adults
IPV
Inactivated poliovirus vaccine
TT
Tetanus toxoid
JE
Japanese encephalitis
TT2+
2 or more doses TT
JE_Live-Atd
JE live attenuated vaccine
VDPV
Vaccine derived poliovirus
JRF
WHO UNICEF joint reporting form
VPD
Vaccine preventable diseases
LB
Live birth
WCBA
Women of child bearing age
M
Measles
WPV
Wild poliovirus
Contents
Page
No.
Impact of rouine immunizaion
EPI history
5
Basic informaion 2016
MCV1 and MCV2 coverage, measles and rubella cases, 1980-2016
Table 1
5
Immunizaion schedule 2016
MCV supplementary immunizaion aciviies
Table 2
5
Naional immunizaion coverage 1980 - 2016
Figure 1
6
Immunizaion system highlights
Table 3
6
DTP3 coverage, diphtheria and pertussis cases 1980 - 2016
Figure 2
7
Reported cases of vaccine preventable diseases 2011 - 2016
Table 4
7
DTP-Hib-HepB3 coverage by province 2016
Figure 3
7
Page
No.
Maternal and neonatal tetanus eliminaion is sustained
TT2+ coverage and NT cases 1980 - 2016
Figure 4
8
Page
No.
Polio-free status is maintained
AFP surveillance indicators 2011 - 2016
Table 5
9
Non-polio AFP rate by province 2015
Figure 5
9
Non-polio AFP rate by province 2016
Figure 6
9
Environmental surveillance sites for polio detecion
Figure 7
10
Adequate stool specimen collecion percentage by province 2015
Figure 8
10
Adequate stool specimen collecion percentage by province 2016
Figure 9
10
OPV supplementary immunizaion aciviies
Table 6
10
Page
No.
Towards measles eliminaion and rubella/congenital rubella
syndrome control
Figure 10
11
Table 7
11
MCV1 coverage by province 2016
Figure 11
12
MCV2 coverage by province 2016
Figure 12
12
Immunity against measles – immunity proile by age in 2016
Figure 13
12
Subnaional risk assessment for measles and rubella
Figure 14
12
Sporadic and outbreak associated measles cases by month 2011 - 2016
Figure 15
12
Immunizaion status of conirmed (laboratory and Epi linked) measles outbreak
associated cases by age 2011 – 2016
Figure 16
12
Quality of ield and laboratory surveillance for measles and rubella 2012 - 2016
Table 8
13
Performance of laboratory surveillance 2012 - 2016
Table 9
13
WHO supported laboratory network for VPD surveillance
Figure 17
14
WHO South-East Asia Region
Thailand: region level map
Disclaimer: The boundaries and names shown and the designaions used on all the maps do not imply the expression of any opinion whatsoever on the part of the
World Health Organizaion concerning the legal status of any country, territory, city or area of its authoriies, or concerning the delimitaion of its froniers or boundaries.
4
Impact of routine immunization
Table 1: Basic information1 2016
EPI history
EPI launched in 1977
1977 - BCG for newborns, DTP for
infants at 2 and 4 months
•
1982 - OPV introducion, 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 naion-wide
•
1993 - Rubella vaccine for 1st grade students
•
1996 - MCV for 1st grade students
•
1997 - MCV and rubella vaccine were
subsituted by MMR for students
•
2000 – JE_Inacted vaccine introduced
countrywide
•
2000 - DTP 5th dose introduced for children
aged 4 years
•
2004 - Inluenza vaccine introduced for HCWs
•
2008 - Inluenza vaccine introduced for
high risk adults
•
2008 - DTP-HepB vaccine introduced
•
2010 - MCV vaccine subsituted with MMR
for 9-12 months infants
•
Age of MMR2 changed to children 2.5 years
in 2014 and launched the campaign to cover
the gap in the age between 2.5-7 years
•
IPV introduced in 2015
•
tOPV to bOPV switched on 29 April 2016
•
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 atenuated vaccine started in 2013
in 8 provinces then expanded to cover
29 Provinces in 2014 and the whole country
in 2016.
Source: cMYP 2012-2016 and EPI/MOH
•
•
Total populaion
65,931,550
Division/Province/State/Region
77
928
Live births
704,058
District
Children 10% drop-out rate for DTP-HepB1 to DTP-HepB3
no data
Source: WHO/UNICEF JRF, 2016
6
Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980-2016
1918 4820
DTP-HepB3 coverage by province
2533
100
800
Figure 3: 2016
700
No. of cases
500
60
400
40
300
200
% Coverage
80
600
20
100
0
0
1980
1985
1990
1995
2000
2005
2010
2011
2012
2013
2014
2015
2016
Year
Diphtheria Cases
Pertussis Cases
DTP3 Coverage
WHO/UNICEF esimates of naional immunizaion coverage, July 2017 revision
WHO vaccine-preventable diseases: monitoring system 2016
1
2
Table 4: Reported cases of vaccine preventable diseases, 2011-2016
Year
Polio
Diphtheria
Pertussis
NT
(% of all Tetanus)
Measles
Rubella
Mumps
JE
CRS
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
2016
0
16
84
0
652
7
23
21
0
Source: WHO/UNICEF JRF, (2011-2016)
ND=No data
7
Source: SEAR annual EPI reporing form, 2016 (administraive data)
90%
Maternal and neonatal tetanus elimination is sustained
Figure 4: TT2+ coverage1 and NT cases2, 1980-2016
MNT eliminaion before 2000
700
100
80
500
400
60
300
200
40
100
0
20
1980
1985
1990
1995
2000
2005
2010
2011
2012
Year
NT Cases
WHO/UNICEF JRF, Country oicial esimates, 1980-2016
WHO vaccine-preventable diseases: monitoring system 2016
1
2
© WHO/Thailand/Migrant Health Serv unit,
Moe Sot Hosp, Tak
8
TT2+ Coverage
2013
2014
2015
2016
% Coverage
No. of cases
600
Polio-free status is maintained
Table 5: AFP surveillance performance indicators, 2011-2016
The last laboratory conirmed polio case due to WPV was reported in April 1997.
Indicator
2011
2012
2013
2014
2015
2016
AFP cases
249
289
235
238
183
246
0
0
0
0
0
0
Wild poliovirus conirmed cases
Compaible cases
0
0
0
0
0
0
Non-polio AFP rate1
1.90
2.21
1.80
1.97
1.36
1.95
Adequate stool specimen collecion percentage2
67%
74%
70%
79%
65%
75%
Total stool samples collected
496
576
444
450
345
464
6
5
5
5
3
8.4
100
100
100
100
100
100
% NPEV isolaion
% Timeliness of primary result reported
3
Number of discarded AFP cases per 100,000 children under 15 years of age.
Percent with 2 specimens, at least 24 hours apart and within 14 days of paralysis onset.
3
Results reported within 14 days of sample received at laboratory.
1
2
Non-polio AFP rate by province
Figure 5: 2015
Figure 6: 2016
© WHO/Thailand/Sansiri Public Company Limited
2
No non-polio AFP case
9
Figure 7: Environmental surveillance sites for poliovirus detection
Adequate stool specimen collection % by province
Figure 8: 2015
Bangkock - 1 site
Samut Sakhon - 1 site
Table 6: OPV SIAs
Year
Anigen
2000
OPV
2001
OPV
2002
Geographic
coverage
Target age
Target populaion
Coverage (%)
Round 1
Round 2
Round 1
Round 2
95
>95
95
>95
OPV
95
>95
2003
OPV
95
>95
2004
OPV
95
>95
2006
OPV
95
>95
2007
OPV
93
>93
2008
OPV
95
>95
2009
OPV
95
>95
2010
OPV
Expanded Programme on Immunization (EPI)
FACT SHEET
Acronyms
AD
Auto disable
MCV1
First dose measles containing vaccine
AEFI
Adverse events following immunization
MCV2
Second dose measles containing vaccine
AFP
Acute flaccid paralysis
MICS
Multiple indicator cluster survey
BCG
Bacillus Calmette-Guérin vaccine
MMR
Measles mumps rubella vaccine
CES
Coverage evaluation survey
MNT
Maternal and neonatal tetanus
cMYP
Comprehensive multi-year plan
MR
Measles rubella vaccine
CRS
Congenital rubella syndrome
NCIP
National committee on immunization practices
DHS
Demographic health survey
NID
National immunization day
DT
Diphtheria tetanus toxoid, pediatric
NTAGI
National technical advisory group on immunization
DTP
Diphtheria – tetanus – pertussis vaccine
NPEV
Non-polio enterovirus
DTP-Hib-HepB
Pentavalent vaccine
NT
Neonatal tetanus
DTP-Hib-HepB3 3rd dose pentavalent vaccine
OPV
Oral poliovirus vaccine
EPI
Expanded programme on immunization
bOPV
Bivalent OPV
GDP
Gross domestic product
tOPV
Trivalent OPV
HCW
Health care worker
PCV
Pneumococcal conjugate vaccine
HepB
Hepatitis B vaccine
SEAR
WHO South-East Asia Region
Hib
Haemophilus influenzae type b
SIA
Supplementary immunization activities
HPV
Human papilloma virus
SNID
Subnational immunization day
IgM
Immunoglobulin M
Td
Tetanus diphtheria toxoid; older children, adults
IPV
Inactivated poliovirus vaccine
TT
Tetanus toxoid
JE
Japanese encephalitis
TT2+
2 or more doses TT
JE_Live-Atd
JE live attenuated vaccine
VDPV
Vaccine derived poliovirus
JRF
WHO UNICEF joint reporting form
VPD
Vaccine preventable diseases
LB
Live birth
WCBA
Women of child bearing age
M
Measles
WPV
Wild poliovirus
Contents
Page
No.
Impact of rouine immunizaion
EPI history
5
Basic informaion 2016
MCV1 and MCV2 coverage, measles and rubella cases, 1980-2016
Table 1
5
Immunizaion schedule 2016
MCV supplementary immunizaion aciviies
Table 2
5
Naional immunizaion coverage 1980 - 2016
Figure 1
6
Immunizaion system highlights
Table 3
6
DTP3 coverage, diphtheria and pertussis cases 1980 - 2016
Figure 2
7
Reported cases of vaccine preventable diseases 2011 - 2016
Table 4
7
DTP-Hib-HepB3 coverage by province 2016
Figure 3
7
Page
No.
Maternal and neonatal tetanus eliminaion is sustained
TT2+ coverage and NT cases 1980 - 2016
Figure 4
8
Page
No.
Polio-free status is maintained
AFP surveillance indicators 2011 - 2016
Table 5
9
Non-polio AFP rate by province 2015
Figure 5
9
Non-polio AFP rate by province 2016
Figure 6
9
Environmental surveillance sites for polio detecion
Figure 7
10
Adequate stool specimen collecion percentage by province 2015
Figure 8
10
Adequate stool specimen collecion percentage by province 2016
Figure 9
10
OPV supplementary immunizaion aciviies
Table 6
10
Page
No.
Towards measles eliminaion and rubella/congenital rubella
syndrome control
Figure 10
11
Table 7
11
MCV1 coverage by province 2016
Figure 11
12
MCV2 coverage by province 2016
Figure 12
12
Immunity against measles – immunity proile by age in 2016
Figure 13
12
Subnaional risk assessment for measles and rubella
Figure 14
12
Sporadic and outbreak associated measles cases by month 2011 - 2016
Figure 15
12
Immunizaion status of conirmed (laboratory and Epi linked) measles outbreak
associated cases by age 2011 – 2016
Figure 16
12
Quality of ield and laboratory surveillance for measles and rubella 2012 - 2016
Table 8
13
Performance of laboratory surveillance 2012 - 2016
Table 9
13
WHO supported laboratory network for VPD surveillance
Figure 17
14
WHO South-East Asia Region
Thailand: region level map
Disclaimer: The boundaries and names shown and the designaions used on all the maps do not imply the expression of any opinion whatsoever on the part of the
World Health Organizaion concerning the legal status of any country, territory, city or area of its authoriies, or concerning the delimitaion of its froniers or boundaries.
4
Impact of routine immunization
Table 1: Basic information1 2016
EPI history
EPI launched in 1977
1977 - BCG for newborns, DTP for
infants at 2 and 4 months
•
1982 - OPV introducion, 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 naion-wide
•
1993 - Rubella vaccine for 1st grade students
•
1996 - MCV for 1st grade students
•
1997 - MCV and rubella vaccine were
subsituted by MMR for students
•
2000 – JE_Inacted vaccine introduced
countrywide
•
2000 - DTP 5th dose introduced for children
aged 4 years
•
2004 - Inluenza vaccine introduced for HCWs
•
2008 - Inluenza vaccine introduced for
high risk adults
•
2008 - DTP-HepB vaccine introduced
•
2010 - MCV vaccine subsituted with MMR
for 9-12 months infants
•
Age of MMR2 changed to children 2.5 years
in 2014 and launched the campaign to cover
the gap in the age between 2.5-7 years
•
IPV introduced in 2015
•
tOPV to bOPV switched on 29 April 2016
•
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 atenuated vaccine started in 2013
in 8 provinces then expanded to cover
29 Provinces in 2014 and the whole country
in 2016.
Source: cMYP 2012-2016 and EPI/MOH
•
•
Total populaion
65,931,550
Division/Province/State/Region
77
928
Live births
704,058
District
Children 10% drop-out rate for DTP-HepB1 to DTP-HepB3
no data
Source: WHO/UNICEF JRF, 2016
6
Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980-2016
1918 4820
DTP-HepB3 coverage by province
2533
100
800
Figure 3: 2016
700
No. of cases
500
60
400
40
300
200
% Coverage
80
600
20
100
0
0
1980
1985
1990
1995
2000
2005
2010
2011
2012
2013
2014
2015
2016
Year
Diphtheria Cases
Pertussis Cases
DTP3 Coverage
WHO/UNICEF esimates of naional immunizaion coverage, July 2017 revision
WHO vaccine-preventable diseases: monitoring system 2016
1
2
Table 4: Reported cases of vaccine preventable diseases, 2011-2016
Year
Polio
Diphtheria
Pertussis
NT
(% of all Tetanus)
Measles
Rubella
Mumps
JE
CRS
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
2016
0
16
84
0
652
7
23
21
0
Source: WHO/UNICEF JRF, (2011-2016)
ND=No data
7
Source: SEAR annual EPI reporing form, 2016 (administraive data)
90%
Maternal and neonatal tetanus elimination is sustained
Figure 4: TT2+ coverage1 and NT cases2, 1980-2016
MNT eliminaion before 2000
700
100
80
500
400
60
300
200
40
100
0
20
1980
1985
1990
1995
2000
2005
2010
2011
2012
Year
NT Cases
WHO/UNICEF JRF, Country oicial esimates, 1980-2016
WHO vaccine-preventable diseases: monitoring system 2016
1
2
© WHO/Thailand/Migrant Health Serv unit,
Moe Sot Hosp, Tak
8
TT2+ Coverage
2013
2014
2015
2016
% Coverage
No. of cases
600
Polio-free status is maintained
Table 5: AFP surveillance performance indicators, 2011-2016
The last laboratory conirmed polio case due to WPV was reported in April 1997.
Indicator
2011
2012
2013
2014
2015
2016
AFP cases
249
289
235
238
183
246
0
0
0
0
0
0
Wild poliovirus conirmed cases
Compaible cases
0
0
0
0
0
0
Non-polio AFP rate1
1.90
2.21
1.80
1.97
1.36
1.95
Adequate stool specimen collecion percentage2
67%
74%
70%
79%
65%
75%
Total stool samples collected
496
576
444
450
345
464
6
5
5
5
3
8.4
100
100
100
100
100
100
% NPEV isolaion
% Timeliness of primary result reported
3
Number of discarded AFP cases per 100,000 children under 15 years of age.
Percent with 2 specimens, at least 24 hours apart and within 14 days of paralysis onset.
3
Results reported within 14 days of sample received at laboratory.
1
2
Non-polio AFP rate by province
Figure 5: 2015
Figure 6: 2016
© WHO/Thailand/Sansiri Public Company Limited
2
No non-polio AFP case
9
Figure 7: Environmental surveillance sites for poliovirus detection
Adequate stool specimen collection % by province
Figure 8: 2015
Bangkock - 1 site
Samut Sakhon - 1 site
Table 6: OPV SIAs
Year
Anigen
2000
OPV
2001
OPV
2002
Geographic
coverage
Target age
Target populaion
Coverage (%)
Round 1
Round 2
Round 1
Round 2
95
>95
95
>95
OPV
95
>95
2003
OPV
95
>95
2004
OPV
95
>95
2006
OPV
95
>95
2007
OPV
93
>93
2008
OPV
95
>95
2009
OPV
95
>95
2010
OPV