Pneumococcal disease in Thailand

Abstract

This review examines the epidemiology of pneumococcal disease, serotype prevalence, antibiotic resistance, and national vaccination recommendations in Thailand. The incidence of invasive pneumococcal disease (IPD) and annualized hospitalization rates for pneumococcal bacteremia in Thailand were highest in children aged <5 years and the elderly. The most prevalent serotype is serotype 6B, which is included in both the 10-and 13-valent pneumococcal conjugate vaccines (PCV10 [also known as PHiD-CV] and PCV13, respectively) registered in Thailand. Other common serotypes are 14, 18C, 19F, and 23F (included in both PCVs) and 6A and 19A (only included in PCV13). PCV10/PHiD-CV and PCV13 should cover 48.8%-74% and 73.2%-92% of isolates among children aged 5 years, respectively, and 40.0%-47.9% and 58.3%-60.9% of isolates among adults aged !65 years. Only PCV13 is licensed for adults in Thailand. Pneumococcal isolates were most commonly resistant to erythromycin, cefuroxime, and penicillin. Despite their demonstrated cost effectiveness and efficacy in reducing nasopharyngeal carriage and IPD, PCVs are not included in the Thai national immunization program. The serotype-specific IPD incidence in Thailand suggests that PCVs will reduce the disease burden in all age groups, but particularly in children and older adults.

Outcomes among Thai children with risk conditions hospitalized for pneumococcal disease (invasive or non-bacteraemic pneumonia): A multi-centre, observational study

“…Between 2007 and 2011, several PCVs (PCV7, PCV10 / PHiD-CV and PCV13) were licensed for use in Thailand. As of 2022, pneumococcal vaccination has not been included in the Thai NIP [ 24 , 25 ]. The current estimated uptake rates of PCV13 and PCV10/ PHiD-CV in Thai children are approximately 13% and 3%, respectively (personal communication with Dr. Wanatpreeya Phongsamart, unpublished data).…”

Factors influencing acceptance of influenza and pneumococcal vaccinations for patients with chronic obstructive pulmonary disease

“…Pneumococcal vaccinations are not free for all people in Thailand because they are not part of Thailand’s national immunization program. 14 However, they are recommended by the Infectious Disease Association of Thailand for adults aged 65 years or older and persons with COPD, heart disease, chronic kidney disease, diabetes, cirrhosis, asplenia, HIV infection, severe immune suppressive state, and organ or bone marrow transplantation. 15 PCV13 or PPSV23 are recommended as pneumococcal vaccinations for COPD patients in Thailand and are considered for revaccination depending on vaccine types.…”

Pneumococcal carriage among high-risk adults in a country with nonmandatory pneumococcal vaccination during the coronavirus disease 2019 pandemic

“…The new higher-valency pneumococcal conjugate vaccines (15-valent and 20-valent pneumococcal conjugate vaccines; PCV15 and PCV20) are nearing adult licensure in high-income countries. However, as of 2022, low- and middle-income countries, including Thailand, had yet to implement pneumococcal vaccines into their national immunization programme [5] . Asymptomatic carriage precedes either PDs or IPDs, with a colonization rate in children ranging from 26.7% to 90.7% [6] , whereas in high-risk adults, the rate can reach 20% [7] , [8] or 32.9%–41.7% [9] .…”

“…Furthermore, carriage data represent an indirect post-deployment effect of pneumococcal vaccination [11] . Carriage data in Thailand are mostly derived from children, and they vary among studies due to differences in methodology and testing methods [5] .…”