Journal of Medical Society

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


Sora Yasri1, Viroj Wiwanitkit2,  
1 KMT Primary Care Center, Bangkok, Thailand
2 Department of Tropical Medicine, Hainan Medical University, Haikou, China

Correspondence Address:
Dr. Sora Yasri
KMT Primary Care Center, Bangkok
Thailand




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;32:236-237


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 13 ];32:236-237
Available from: http://www.jmedsoc.org/text.asp?2018/32/3/236/251989


Full Text

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 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. [INSIDE: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}

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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