According to a 2023 report from Ministry of Public Health, Thailand, over 300,000 Thai people were infected with influenza. Specialists believe probably one million people annually come down with the flu due to year-round occurrence. Moreover, unvaccinated people are at greater risk of recurring flu infection and the elderly are susceptible to flu-related severe illness or deaths because comorbidities can complicate their symptoms. The Influenza Foundation (Thailand) calls on the Thai Government to increasing offer free flu shot to people over 65 years of age and expand free flu vaccination to cover more school children who are likely to spread the disease. The flu vaccine is worth this investment and has been recognised as a cost-effective preventive measure for over 80 years.
Associate Professor Tawee Chotpitayasunondh, President of the Influenza Foundation (Thailand), reveals “flu is a seasonal disease. Since COVID-19, fewer people have been catching the flu due to preventive measures and so people are now less immune to it. According to the report from Ministry of Public Health, during the January-October period of 2023, over 300,000 flu patients were infected with influenza and 21 of them died. In fact, many more with less severe illness were infected without needing hospital admission. The report did not include patient data from those who did not receive treatment due to mild symptoms or those who received treatment at private clinics. It is believed by the end of 2023 probably one million people will have experienced a flu infection.”
"Analysis of flu infection data in Thailand reveals a distinct seasonal outbreak contrast with countries located in temperate climates, like the US, certain European countries, Japan, or Korea. In those regions, flu is seasonal, mostly peaking in winter and waning or nearly disappear in warmer months. However, Thailand, located in the tropical zone, experiences flu outbreak consistently throughout the year. The rainy season will see a surge in cases due to high humidity, increased close contact in enclosed spaces, and the beginning of the school semester. These factors contribute to flu transmission within families, putting at increased risk both young children and the elderly, who face greater risk of severe illness or death due to comorbid conditions. However, young adult flu cases are typically less severe without complication. In summary, influenza appears year-round, affecting all age groups, and vaccination is the most cost effective for flu prevention in all age groups as well."
Associate Professor Tawee adds, “research regarding influenza-related hospital admission in Thailand measured the direct and indirect economic costs of the flu – finding that the annual direct cost of flu treatment is 1.1 billion THB and the annual indirect loss of business/work opportunities is 1.3 billion THB. So, the annual cost of the flu in Thailand is 2.4 billion THB. However, the best and most cost-effective measures for influenza prevention is vaccination. The Thai Government currently offers free flu vaccination to people of at-risk groups, including young children, people with certain comorbid conditions, pregnant women, and the elderly.”
Since Thailand is an aging society, we must expand flu prevention and control measures, including providing free vaccines more accessible. For example, Thailand should make use of teams of multidisciplinary healthcare professionals to provide vaccination services at drive-thru stations, like in the US and Europe. Associate Professor Tawee believes the flu vaccine holds the highest level of acceptance among Thai society, since it has been safely administered for over 50 years. The flu vaccine’s record of efficacy and safety prove it is worth the investment. Regarding the elderly at risk of flu-related severe illness or death, the vaccine lessens the severity of symptoms & complications, duration of hospital stays, and mortality. If the Thai Government would increase the number of free doses distributed to the elderly and other at-risk groups – especially children who are an important transmitter or for flu virus in addition to being an at-risk group, the financial burden of the flu could be greatly reduced.
Professor Sasisopin Kiertiburanakul, Chief of the Division of Infectious Diseases, Faculty of Medicine Ramathibodi Hospital, Mahidol University reveals “the elderly are susceptible to flu infection for three reasons. The first is lower immunity as when we are older, our ability to fight off infection decreases. We cannot fight off germs the way we could when we were young. So, the elderly are easily infected by the influenza virus. When infected, their symptoms can be severe. Secondly, the elderly usually suffer from other comorbid health conditions. For example, some elderly people suffer from emphysema. When they catch the flu, they become even shorter of breath as the virus infects the lungs, leading to life-threatening symptoms. Some have heart conditions, and the flu can worsen heart health. If they have diabetes, the immune system is weakened, causing complications and other comorbidities. Lastly, elderly people can be malnourished. They generally eat less and do not get enough nutrients in their diets. These factors contribute to higher chances of catching the flu and higher risks that their symptoms would become severe.”
These factors are the main reasons why the elderly should be vaccinated. The benefits of vaccination against the flu include reduced symptoms, reduced pulmonary inflammation, and lower risk of hospitalisation and death. There are also steps we can take in daily life to reduce flu transmission like mask wearing, frequent hand washing, social distancing. However, these steps cannot be taken all the time and they alone cannot reduce the risk to zero.
The Infectious Disease Association of Thailand recommends everyone 6 months of age and up get vaccinated against the flu. Currently, there are 2 types of flu vaccines available in Thailand:
- The standard dose contains 15 mcg of antigen per strain of flu per dose. It is appropriate for everyone 6 months of age and up, including the elderly.
- The high dose contains 60 mcg of antigen per strain of flu per dose. It is an option for those at higher risk – like being 65 or older and is better at symptom reduction than the standard dose by 24%, while further reducing the risk of hospitalisation, pneumonia, and death by greater margins than those of the standard dose. However, injection site pain can be a little more acute for patients receiving a high dose vaccine.
Associate Professor Tawee closed by commenting, “The important thing I want to stress about the flu vaccine is there is no need to wait one full year between shots. People should get vaccinated as soon as the new flu vaccine comes out, usually between April and May, as long as 6 months have passed since the date of last vaccination. Members of government mandated at-risk groups can get vaccinated free of charge at public hospitals or by calling the 1422 hotline. The general public can receive the flu vaccine at either public or private hospitals at their own expense.”