Comparing 3 Approaches for Making Vaccine Adoption Decisions in Thailand

Document Type : Original Article


1 Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand

2 Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

3 Asc Academics, Groningen, The Netherlands

4 World Health Organization (WHO), Genève, Switzerland


The World Health Organization (WHO) has developed the Total System Effectiveness (TSE) framework to assist national policy-makers in prioritizing vaccines. The pilot was launched in Thailand to explore the potential use of TSE in a country with established governance structures and accountable decision-making processes for immunization policy. While the existing literature informs vaccine adoption decisions in GAVI-eligible countries, this study attempts to address a gap in the literature by examining the policy process of a non-GAVI eligible country.

A rotavirus vaccine (RVV) test case was used to compare the decision criteria made by the existing processes (Expanded Program on Immunization [EPI], and National List of Essential Medicines [NLEM]) for vaccine prioritization and the TSE-pilot model, using Thailand specific data.

The existing decision-making processes in Thailand and TSE were found to offer similar recommendations on the selection of a RVV product.

The authors believe that TSE can provide a well-reasoned and step by step approach for countries, especially low- and middle-income countries (LMICs), to develop a systematic and transparent decision-making process for immunization policy.



Supplementary file 1 contains Tables S1-S3 and Supplementary file 2 shows the detailed methodology for estimating the vaccine performance based on decision criteria.



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Volume 9, Issue 10
October 2020
Pages 439-447
  • Receive Date: 10 May 2019
  • Revise Date: 23 December 2019
  • Accept Date: 01 January 2020
  • First Publish Date: 01 October 2020