WHO snubbed on vaccine advice


The Public Health Ministry has dismissed a recommendation from the World Health Organisation (WHO) to use the national health scheme to vaccinate children under five against serious bacterial infections, saying the rate of mortality was very low.

Disease Control Department (DCD) director-general Dr Thawat Suntrajarn said the National Vaccine Committee, which comes under the DCD, had recently decided not to use the vaccine for invasive pneumococcal disease (IPD). The WHO estimates the disease kills 1,000 children in Thailand every year.

"I want to say that incidents of IPD right now are not a burden on the public's health in Thailand. We still can control and service the incidents by using antibiotics, so using a vaccine is not necessary at this time," he said.

Thawat said another point of concern was the cost of the vaccine, which is very high at about Bt4,000 per injection.

National Health Security Office secretary-general Sa-nguan Nityarumpong said it would be impossible to include the IPD vaccine in the national vaccination programme because of the high price of the drug, but the agency needed to consider the matter in more detail.

"We have to be concerned about the people's health as a priority. We then have to consider the efficacy and the budget. If it doesn't meet these criteria it would be impossible to use the vaccine," Sa-nguan said.

The ministry's decision was opposed by the president of the Paediatric Infectious Diseases Society of Thailand, Dr Somsak Lolekha, who said IPD had become the primary killer of children aged under five.

"Even if the death rate is quite small we need a vaccine to help these children - especially poor children," Somsak said.

He said many developed countries - including the United Kingdom, France, Canada, Austria and the United States - provided IPD vaccine to their children.

Somsak said the WHO report published recently said that every year about 2 million children around the world die from pneumonia, with one in five killed by IPD.

IPD causes middle-ear infection, pneumonia, blood-stream infections (bacteremia), sinus infections and meningitis.

The symptoms of meningitis, the severest form of IPD, include high fever, headache and a stiff neck, which can develop over several hours or one to two days. Other symptoms may include nausea, vomiting, discomfort when looking into bright lights, confusion and sleepiness.

IPD can kill patients in just two days in the case of a severe infection, and the death rate for IPD meningitis patients is high.

Most children under five with pneumonia receive antibiotics, but the WHO reported a high level of antibiotic resistance to first-line treatment and expects control to be more difficult in the future.

Somsak said the WHO recommended using a vaccine as a key action to reduce the pneumonia death rate among children, but due to the high cost it was mostly available only in private hospitals.

"The Public Health Ministry should provide this vaccine as part of a national vaccination programme to save children's lives. The treatment should be free of charge for poor children because of the high price of the vaccine," he said.

Pongphon Sarnsamak
The Nation