Landscape of vaccine access and health technology assessment role in decision-making process in ASEAN countries

Figures & data

Table 1. Access to vaccine through national immunization program among ASEAN countries.

	Singapore	Thailand	Malaysia	Brunei	Philippines	Indonesia	Cambodia	Lao PDR	Myanmar	Vietnam
Emerging vaccines
PCV	2009^Citation14	X	X	X	2013^Citation14	2017^Citation14	2015^Citation14	2013^Citation14	2016^Citation14	X
RV	X	2019^Citation19	X	X	X	X	X	(Planned)^Citation14	(Planned)^Citation14	(Planned)^Citation14
HPV	2010^Citation12,Citation14	2017^Citation11,Citation14	2010^Citation13,Citation14	2012^Citation14	2016^Citation10,Citation14	2016^Citation14	X	2019^Citation14	(Planned)^Citation14	X
CYD-TDV	X	X	X	X	2017^Citation21	(Planned)^Citation5	X	X	X	X
Combined vaccines
DTwP-Hib-HB	X	2019^Citation22	X	X	2013^Citation23	2013^Citation24	2010^Citation24	2009^Citation24	2012^Citation24	2010^Citation24
DTaP-Hib-IPV	2013^Citation14,Citation25	X	2009^Citation14	X	X	X	X	X	X	X
DTaP-Hib-HB-IPV	X	X	X	Yes*^Citation26	X	X	X	X	X	X

*No data on when the vaccine is available in NIP.

Sources: World Health Organization, Gavi the Vaccine Alliance, National Immunization Program in each country.

Table 2. Decision framework for the introduction of new vaccine.

	Singapore	Brunei	Thailand	Malaysia	Philippines	Indonesia	Cambodia	Lao PDR	Myanmar	Vietnam
Gavi-eligible country (Gavi-graduating year)^Citation33	No	No	No	No	No	Recently graduated (2018)	Yes (TBC)	Yes (2022)	Yes (TBC)	Yes (2020)
NITAGs establishment	1975 as ECI^Citation34	No^Citation26	1970 as ACIP^Citation34	2008 as NCIP^Citation34	1986 as NIC^Citation23	2007 as ITAGI^Citation35	2016^Citation26	2013^Citation34	2009 as NCIP^Citation34	1998*^Citation34
Decision makers regarding new vaccine adoption^Citation5	MoH	MoH	NEDL	NCIP	DoH	ITAGI	NITAGs	NITAG	MOHS	MoH (HITAP)
HTA guideline	No	No	Third edition expected in 2020^Citation36	Health Technology Assessment Manual 2015^Citation37	Draft guideline^Citation38	Health Technology Assessment Guideline 2017^Citation39	No	No	No	No
HTA agency	ACE^Citation40	No	HITAP^Citation36	MaHTAS^Citation37	Yes (not named yet)^Citation38	InaHTAC^Citation39	No	No	No	No
Required HTA for new vaccine adoption in NIP	Yes^Citation40	No	Yes^Citation36	Yes^Citation37	Yes^Citation38	Yes^Citation39	No	No	No	No
The importance of the health problem	BOD^Citation5	N/A	BOD, Severity of diseases^Citation5,Citation41	BOD	N/A	BOD^Citation42	N/A	N/A	N/A	N/A
Vaccine characteristics	Safety and efficacy^Citation5	N/A	Safety and efficacy^Citation5,Citation41	Safety and efficacy^Citation37	Safety and efficacy^Citation2	Effectiveness and safety^Citation42	N/A	N/A	N/A	N/A
Financial economic issues	EE^Citation5	N/A	EE^Citation5,Citation41	EE^Citation37	EE^Citation2	EE, Sustainability, Financing^Citation42	N/A	N/A	N/A	N/A
Ethical, organizational, social, and legal aspects	N/A	N/A	- Equity - Target age group^Citation41	- Strategy for service - Delivery - Monitoring and surveillance - Regulatory^Citation37	N/A	- Vaccine availability - Capability to produce the vaccine (in some vaccine)^Citation42	N/A	N/A	N/A	N/A

*SIVAC has been supporting the strengthening of the committee since September 2010.

TBC = To be confirmed, ECI = Expert Committee on Immunization, MoH = Ministry of Health, ACIP = the Advisory Committee on Immunization Practices, NEDL = Health Promotion and Disease Control and National Essential Drugs List, NCIP = the National Committee on Immunization Practices, NIC = The National Immunization Committee, DoH = Department of Health, ITAGI = the Indonesian Technical Advisory Group on Immunization, NITAGs = National Immunization Technical Advisory Groups, MOHS = the Ministry of Health and Sports, HITAP = The Health Intervention and Technology Assessment, ACE = Agency for Care Effectiveness, MaHTAS = The Malaysian Health Technology Assessment Section, InaHTAC = Indonesian Health Technology Assessment Committee, BOD = Burden of Disease study, EE = Economic Evaluation study, N/A = Not applicable

Sources: World Health Organization, Gavi the Vaccine Alliance, HTA report in each country, NITAGs resource center.

Bruni LAG, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S Human papillomavirus and related diseases in Malaysia. Summary report. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre); 17 June 2019.

 Google Scholar

Turner P, Turner C, Suy K, Soeng S, Ly S, Miliya T, Goldblatt D, Day NPJ. Pneumococcal infection among children before introduction of 13-valent pneumococcal conjugate vaccine, Cambodia. Emerg Infect Dis. 2015;21(11):2080–83. doi:10.3201/eid2111.150914.

 PubMed Web of Science ®Google Scholar

Bruni LAG, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S Human papillomavirus and related diseases in Thailand. Summary report. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre); 17 June 2019.

 Google Scholar

Bruni LAG, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S Human papillomavirus and related diseases in Philippines. Summary report. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre); 17 June 2019.

 Google Scholar

Bruni LAG, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S Human papillomavirus and related diseases in Singapore. Summary report. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre); 17 June 2019.

 Google Scholar

L Ag B, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S Human papillomavirus and related diseases in Brunei. Summary report. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre); 17 June 2019.

 Google Scholar

Abou-Nader AJ, Sauer MA, Steele AD, Tate JE, Atherly D, Parashar UD, Santosham M, Nelson EAS. Global rotavirus vaccine introductions and coverage: 2006 – 2016. Hum Vaccin Immunother. 2018;14(9):2281–96. doi:10.1080/21645515.2018.1470725.

 PubMed Web of Science ®Google Scholar

Burchett HED, Mounier-Jack S, Griffiths UK, Mills AJ. National decision-making on adopting new vaccines: a systematic review. Health Policy Plan. 2011;27(suppl_2):ii62–ii76. doi:10.1093/heapol/czr049.

 PubMedGoogle Scholar

Doherty J. Effective capacity-building strategies for health technology assessment: a rapid review of international experience. South Africa: Discussion Document. School of Public Health, University of the Witwatersrand; 2015.

 Google Scholar

MacDonald NE, Duclos P, Wichmann O, Henaff L, Harnden A, Alshammary A, Tijerino RA, Hall M, Sacarlal J, Singh RR, et al. Moving forward on strengthening and sustaining National immunization technical advisory groups (NITAGs) globally: recommendations from the 2nd global NITAG network meeting. Vaccine. 2017;35(50):6925–30. doi:10.1016/j.vaccine.2017.10.048.

 PubMed Web of Science ®Google Scholar

Pediatric department Siriraj hospital. Immunisation schedule for newborn to 18-month child. 2017 [updated 2017] [cited 2020 Jan 19]. https://www.si.mahidol.ac.th/th/department/pediatrics/pdf/service/leftlet/InfectiousDiseases/vaccine_siriraj2560.pdf.

 Google Scholar

Adjagba A, Henaff L, Duclos P. The NITAG resource centre (NRC): A one-stop shop towards a collaborative platform. Vaccine. 2015;33.

 PubMed Web of Science ®Google Scholar

Edwards K, Decker M. Pertussis vaccine 5th. USA. p. 471–528.

 Google Scholar

Gavi The Vaccine Alliance. Eligibility. 2019 [updated 2019] [accessed 2020 Jan 09]. https://www.gavi.org/types-support/sustainability/eligibility.

 Google Scholar

Liverani M, Chheng K, Parkhurst J. The making of evidence-informed health policy in Cambodia: knowledge, institutions and processes. BMJ Global Health. 2018;3(3):e000652–e. doi:10.1136/bmjgh-2017-000652.

 PubMed Web of Science ®Google Scholar

Rattanavipapong W, Kapoor R, Teerawattananon Y, Luttjeboer J, Botwright S, Archer RA, Giersing B, Hutubessy RCW. Comparing 3 approaches for making vaccine adoption decisions in Thailand. Int J Health Policy Manage. 2020. doi:10.15171/ijhpm.2020.01.

 PubMed Web of Science ®Google Scholar

Bakri DDR, Sabirin J, Fuzi SAM, Rahman MA, Mohamad NF, Rashid RAM Health technology assessment manual. Malaysia: Medical Development Division, Ministry of Health; 2015 [cited 2020 Jan 09]. https://apps.who.int/medicinedocs/documents/s22255en/s22255en.pdf.

 Google Scholar

Gavi The Vaccine Alliance. Transitioning out of Gavi support 2019 [updated 2019] [accessed 2020 Jan 09]. https://www.gavi.org/types-support/sustainability/transition.

 Google Scholar

Wilder-Smith A, Flasche S, Smith PG. Vaccine-attributable severe dengue in the Philippines. Lancet. 2019;394(10215):2151–52. doi:10.1016/S0140-6736(19)32525-5.

 PubMed Web of Science ®Google Scholar

World Health Organization. 2019. Global Vaccine Action Plan. Regional reports on progress towards GVAP-RVAP goals, Annex to the GVAP review and lessons-learned report.

 Google Scholar

Ongpoy R. The National immunization committee (NIC), A Philippine NITAG (National Immunization Technical Advisory Group). J Asian Asso Schools Pharm. 2017;6:47–54.

 Google Scholar

Tiong Wei Wei YK. Childhood immunization Health Mo, editor. Singapore. p. 121–33.

 Google Scholar

World Health Organization. Regional office for South-East A. The establishment and operation of national immunization technical advisory groups in the WHO South-East Asia Region. New Delhi: World Health Organization. Regional Office for South-East Asia; 2016. p. 2016.

 Google Scholar

Griesenauer RH, Kinch MS. An overview of FDA-approved vaccines & their innovators. Expert Rev Vaccines. 2017;16(12):1253–66. doi:10.1080/14760584.2017.1383159.

 PubMed Web of Science ®Google Scholar