Death Reports under Surveillance of Adverse Events Following Immunization in Thailand, 2010 - 2012

Abstract

Eight types of vaccines under Expanded Program on Immunization in Thailand are used to prevent 10 vaccine preventable diseases such as tuberculosis, diphtheria, pertussis, tetanus, polio, measles, rubella, mump, hepatitis and Japaness encephalitis. Besides those vaccines, Ministry of Public Health has also introduced seasonal influenza vaccine for preventing high risk people from influenza outbreak since 2008 and pandemic influenza vaccine in 2010. Passive surveillance system has been operated by Bureau of Epidemiology for monitoring adverse events following immunization (AEFI) and causality assessment has also been performed by AEFI Expert Review Committee. Since 2010-2012, fifty deaths after those vaccines administration were reported. Of these, eighty percent were assessed to be coincidental events. Causes of deaths were shown as congenital malformations, chronic diseases underlying, other infectious diseases and other causes. Twenty percent, the causes could not be concluded due to insufficient data in lacking of dead scenes data, events during illness at the patient’s houses, laboratory investigation data and pathological data on autopsy. For these results, AEFI investigation teams should be strengthened to increase knowledge and investigation skill including performing network of medical specialists in AEFI investigation teams to contribute in laboratory investigation. In case of deaths by congenital malformations or chronic diseases underlying, the recommendation to prevent deaths is vaccination at hospitals to get examination by doctor before vaccination and also be observed abnormality after vaccination.