typhoid vaccine used in vietnam and its impact typhoid vaccine i… · typhoid vaccine used in...
TRANSCRIPT
Typhoid Vaccine Used in Vietnam and its Impact
Ad-Hoc Consultation on Typhoid Vaccine Introduction and Typhoid Surveillance,
18-20 April 2011, Bangkok, ThailandNguyen 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 VietnamVaccine Schedule Year start % Coverage
area 2010BCG 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: 3-5Y2,080 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, 1997-2010Year 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 0,260,49
0,700,47 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
US
$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
Num
ber o
f cas
es
Vacc
ine
dose
s gi
ven
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