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 Table of Contents  
LETTERS TO EDITOR
Year : 2018  |  Volume : 32  |  Issue : 3  |  Page : 236-237

Severe adverse effect due to available cervix cancer vaccine and vaccination cost: Implication from preliminary program for universal vaccination among local Thai primary school children


1 KMT Primary Care Center, Bangkok, Thailand
2 Department of Tropical Medicine, Hainan Medical University, Haikou, China

Date of Web Publication11-Feb-2019

Correspondence Address:
Dr. Sora Yasri
KMT Primary Care Center, Bangkok
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jms.jms_23_18

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How to cite this article:
Yasri S, Wiwanitkit V. Severe adverse effect due to available cervix cancer vaccine and vaccination cost: Implication from preliminary program for universal vaccination among local Thai primary school children. J Med Soc 2018;32:236-7

How to cite this URL:
Yasri S, Wiwanitkit V. Severe adverse effect due to available cervix cancer vaccine and vaccination cost: Implication from preliminary program for universal vaccination among local Thai primary school children. J Med Soc [serial online] 2018 [cited 2019 Nov 17];32:236-7. Available from: http://www.jmedsoc.org/text.asp?2018/32/3/236/251989

Sir,

The cervix cancer is an important female malignancy seen worldwide and causes a number of deaths annually.[1] The use of cervix cancer vaccine is the new preventive approach against this important cancer. In Thailand, there is a high incidence of cervix cancer, and it is the most common cause of malignancy-related death among Thai women. According to the present public health policies in Thailand, the implementation of universal cervix cancer vaccination for primary school age girl (aged 10–12 years old) is added to the routine-free annual  Pap smear More Details screening.[2] The introduction of the cervix cancer vaccine is an interesting attempt. For implementation, the cost-effectiveness of the vaccine is the first important concern, and it is approved by several previous reports worldwide.[3],[4],[5],[6] At present, there are only two registered cervix cancer vaccines in Thailand, Gardasil, and Cervarix, which are all included in Thai National Drug List. The concern on using of both vaccines becomes important issue in clinical decision-making. The local cost of vaccine becomes the big consideration. In addition, the additional concern is on the possible severe side effect of the vaccine. This information has never been available in the country, and the referring to the previously published reports might mislead the decision-making for vaccine selection. There was a recent trial of the available vaccine among local Thai primary school girls in a province of Thailand (5400 participants) (details available on http://thaigcd.ddc.moph.go.th/uploads/file/EPI/1. ). Here, the authors tried to analyze the reported data from that trial program focusing on cost and reported severe side effect due to vaccination. A standard cost and risk analysis of the available cervix cancer vaccines in Thailand, namely Gardasil and Cervarix, is done. The cost in this work is referred to the 2017 revised unit cost per dose of vaccine due to Thai governmental control of vaccine for universal implementation of cervix cancer vaccination. The cost is calculated in USD is used for further analysis. Focusing on the risk, the data from mentioned local Thai trial is used. Data on cost and risk are shown in [Table 1]. Of interest, the data from recent trial in Thailand showed that there is no difference in observed adverse effect to vaccines (only mild adverse effects such as pain and fever in <1% for any vaccinations). There is no case of severe adverse effect due to vaccinations. These data are significantly different from the previous report from the Western countries.[7] Based on this information, the risk of any available vaccines should be the same and the cost of the vaccine becomes the important parameters for decision-making in selection of available vaccines for clinical usage. Further data from actual implementation of the universal cervix cancer vaccination program is useful To fulfill the present data in this report.
Table 1: Cost-risk analysis of available cervix cancer vaccines in Thailand

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Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Torre LA, Islami F, Siegel RL, Ward EM, Jemal A. Global cancer in women: Burden and trends. Cancer Epidemiol Biomarkers Prev 2017;26:444-57.  Back to cited text no. 1
    
2.
Wiwanitkit V. Screening for cervical cancer, results from Thailand. Asian Pac J Cancer Prev 2006;7:329-30.  Back to cited text no. 2
    
3.
Einstein MH, Baron M, Levin MJ, Chatterjee A, Edwards RP, Zepp F, et al. Comparison of the immunogenicity and safety of cervarix and gardasil human papillomavirus (HPV) cervical cancer vaccines in healthy women aged 18-45 years. Hum Vaccin 2009;5:705-19.  Back to cited text no. 3
    
4.
Draper E, Bissett SL, Howell-Jones R, Waight P, Soldan K, Jit M, et al. Arandomized, observer-blinded immunogenicity trial of cervarix(®) and gardasil(®) human papillomavirus vaccines in 12-15 year old girls. PLoS One 2013;8:e61825.  Back to cited text no. 4
    
5.
Song X, Mao F, Zhou Z, Zhao Q, Fang Y. Health economic evaluation of human papillomavirus vaccines in the developing countries: Systematic reviews. Zhonghua Yu Fang Yi Xue Za Zhi 2016;50:85-90.  Back to cited text no. 5
    
6.
Pimple S, Mishra G, Shastri S. Global strategies for cervical cancer prevention. Curr Opin Obstet Gynecol 2016;28:4-10.  Back to cited text no. 6
    
7.
Haskins-Coulter T, Southern J, Andrews N, Miller E. Reactogenicity of cervarix and gardasil human papillomavirus (HPV) vaccines in a randomized single blind trial in healthy UK adolescent females. Hum Vaccin Immunother 2017;13:1-9.  Back to cited text no. 7
    



 
 
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