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Hexavalent vaccines against diphtheria (D), tetanus (T), pertussis (P), hepatitis B (HBV), polio (IPV) and Haemophilus influenzae b (Hib) are established in the immunization of infants in many countries. A metaanalysis of results from six head-to-head clinical trials comparing two hexavalent vaccines reported that the rate of three local (redness, pain and swelling at the injection site) and five systemic (fever, drowsiness, persistent crying, irritability and anorexia) adverse reactions was lower for the DT3aP-HBV-IPV/Hib vaccine than for the DT2aP-HBV-IPV-Hib vaccine. The objective of this analysis was to compare the impact of adverse reactions after a single dose of the primary series of DT3aP-HBV-IPV/Hib vaccine versus DT2aP-HBV-IPV-Hib vaccine in the infant populations of four countries in Southeast Asia (Indonesia, Malaysia, the Philippines and Thailand). A previously published mathematical projection tool was combined with published data to estimate the number of adverse reactions potentially avoided in 2023 by using DT3aP-HBV-IPV/Hib vaccine compared with DT2aPHBV-IPV-Hib vaccine. The results indicated that for every 100 infants vaccinated, using DT3aP-HBV-IPV/Hib instead of DT2aP-HBV-IPV-Hib would be expected to avoid adverse reactions, ranging from 3 events of swelling at the injection site to 10 events of fever. In 2023, over 280,000 solicited local and systemic adverse reactions of any grade could have been avoided in Indonesia, over 200,000 in Malaysia, over 80,000 in Thailand and over 158,000 in the Philippines. These results could be useful to healthcare decision-makers considering immunization strategies in Southeast Asia. [ABSTRACT FROM AUTHOR]

Introduction: Herpes zoster (HZ; i.e., shingles) is caused by the reactivation of varicella zoster virus leading to a painful dermatomal rash. An increasing trend in cases of HZ is evident worldwide; however, there is a lack of comprehensive reviews for Southeast Asian countries. Methods: We performed a systematic literature review of articles published until May 2022 that reported HZ epidemiology, clinical management, and health economic data in six Southeast Asian countries: Indonesia, Malaysia, the Philippines, Singapore, Thailand, and Vietnam. Literature searches were conducted in Medline, Scopus, Embase, and gray literature. Articles written in English or local languages were considered for inclusion. Results: In total, 72 publications were included in the study; 22 were case studies and over 60% originated in Singapore and Thailand. Only two studies (data from Thailand) reported incidence of HZ. The proportion of patients reported with HZ was 0.68–0.7% among dermatology clinics, 0.14% at one emergency department (5.3% of dermatology cases) in Singapore, and 3% of admissions at another hospital in Singapore. Pain was the most common symptom associated with HZ, reported in 74.21–100% of patients. HZ complications were reported in 10.2–21.2% of patients, and the proportions with postherpetic neuralgia and HZ ophthalmicus were 6.3–50% and 4.98–28.57%, respectively. Additionally, there is a lack of comprehensive, up-to-date HZ economic data, with only six studies identified for the Philippines, Singapore, and Thailand. Conclusions: Overall, there are limited data reporting incidence and prevalence of HZ in Southeast Asia at a national level. High rates of complications, symptoms, and abundance of case reports suggest substantial healthcare resource utilization for patients with HZ and highlight the need for further research in Southeast Asia assessing the societal impact. [ABSTRACT FROM AUTHOR]