Influenza surveillance and vaccine policy in Thailand—a historical perspective

Prior to 2000, influenza burden in Thailand and other low- and middle-income countries was underappreciated, and influenza vaccination was uncommon. For the last two decades, Thailand Ministry of Public Health (MOPH) and U.S. Centers for Disease Control and Prevention have collaborated to understand influenza burden and the costs and benefits of influenza vaccination in Thailand. Built on a long-standing national disease notification system, Thailand MOPH established robust surveillance platforms for pneumonia and influenza, which provided insights into seasonality, disease incidence, and populations at risk for severe disease. In 2004, human cases of avian influenza brought attention to influenza's pandemic potential. Concern for an influenza pandemic combined with evidence of the cost effectiveness of influenza vaccination accelerated vaccine policy. Surveillance and vaccination policy were leveraged for and strengthened by the 2009 influenza H1N1 and COVID-19 pandemics. This personal view documents Thailand's experience in developing influenza surveillance and influenza vaccination policy.