The National Vaccine Institute (NVI), in partnership with the Department of Disease Control (DDC), is advancing a policy framework that enables Local Administrative Organizations (LAOs) to participate more actively in vaccine procurement. This initiative aims to supplement the National Immunisation Program by expanding access to routine and essential vaccines, thereby strengthening protection against vaccine-preventable diseases for vulnerable populations, including young children, the elderly, and individuals with underlying health conditions. By leveraging LAOs’ close ties to local communities, the policy seeks to enhance disease prevention and control through coordinated efforts with Provincial Health Offices (PPHOs) and Subdistrict Health Promoting Hospitals (SHPHs). The National Vaccine Committee has approved two vaccines for LAO procurement: an influenza vaccine for at-risk groups and the pneumococcal conjugate vaccine (PCV) for children under five. The program emphasizes a cross-sectoral approach to vaccine access, recognizing that local governance and community engagement are critical to expanding coverage and ensuring timely protection. As the policy moves into the implementation phase, it signals a significant step toward decentralizing procurement authority, strengthening Thailand’s disease prevention infrastructure, and fostering a robust, collaborative vaccine ecosystem across regions. pilot experiences in ready provinces demonstrate the potential for broader impact as the policy scales.
Policy Framework and Objectives
The policy framework guiding LAO participation in vaccine procurement is rooted in a strategic goal to fortify national immunization efforts through local leadership and targeted resource deployment. Central to this framework is the belief that vaccines reach communities more effectively when procurement decisions are informed by local epidemiology, risk profiles, and health-seeking behaviors. The initiative aligns with the broader public health objective of reducing illness, hospitalization, and mortality from vaccine-preventable diseases by extending the reach of life-saving vaccines beyond centralized channels. A core objective is to create a seamless interface among national authorities, provincial health systems, and local governance bodies, ensuring that procurement processes are transparent, accountable, and responsive to local needs. The framework emphasizes governance mechanisms that balance decentralized decision-making with overarching national standards for safety, efficacy, and quality. It also prioritizes data-driven planning, enabling LAOs to forecast demand, manage inventories, and monitor vaccine utilization with consistent reporting across jurisdictions. Equity is a foundational pillar, guiding the distribution of vaccines to under-served or hard-to-reach populations and ensuring that vulnerable groups receive timely protection. The framework calls for ongoing capacity-building, including training for local officials in procurement, cold chain management, logistics, and routine data collection. In addition, it establishes a collaborative culture across sectors—health, finance, logistics, and community organizations—so that LAOs can mobilize the necessary resources and expertise to sustain vaccine access.
A comprehensive supervision and evaluation plan accompanies the framework. This plan outlines performance indicators, milestones, and feedback loops designed to track progress, identify bottlenecks, and refine processes. It recognizes that procurement is only one component of vaccine delivery; the assurance of cold-chain integrity, proper storage, timely distribution, and adherence to immunization schedules are equally vital. The policy also fosters resilience by anticipating supply fluctuations and establishing contingency mechanisms to safeguard continuity of vaccination services. By embedding risk assessment and risk management into the procurement cycle, the framework seeks to minimize gaps that could undermine vaccination coverage. In sum, the policy framework aims to enable LAOs to act as efficient, accountable catalysts for local vaccine access, while preserving the integrity of national immunization objectives and protecting public health across all regions.
Roles of Local Administrative Organizations in Vaccine Procurement
LAOs are positioned at the confluence of governance, community trust, and local health needs. Their proximity to residents makes them uniquely capable of identifying barriers to vaccine access, communicating benefits, and mobilizing community support for immunization programs. The policy assigns LAOs a pivotal role in procuring vaccines that supplement, rather than replace, the National Immunisation Program. Their responsibilities include planning and forecasting vaccine needs based on population demographics, epidemiological patterns, and local risk factors; coordinating with health facilities, PPHOs, and SHPHs to align supply with demand; and overseeing the logistics of procurement, storage, and distribution within their jurisdictions. LAOs are expected to engage local stakeholders—community leaders, schools, healthcare providers, and civil society organizations—in the planning and dissemination of vaccination campaigns, thereby strengthening trust and uptake. The collaboration with PPHOs and SHPHs is essential, as these entities provide clinical oversight, vaccination services, and data for monitoring program performance at the subnational level. By integrating their community networks with official health systems, LAOs can identify underserved populations, adapt outreach strategies, and ensure that vaccination services reach all eligible residents, including those who face access barriers.
Strengthening vaccine access through LAOs also involves building procurement capacity and governance structures at the local level. This includes establishing transparent procurement processes, ensuring compliance with national safety and quality standards, and instituting robust inventory management practices to prevent stockouts and wastage. LAOs are expected to implement clear accountability mechanisms, including financial controls, performance reporting, and regular program audits. The collaboration framework emphasizes joint planning and decision-making, allowing LAOs to contribute local insights to procurement priorities while adhering to national guidelines. In practice, LAOs serve as logistical hubs that coordinate orders, receive vaccines, and allocate supplies to participating health facilities and outreach sites. They also play a critical role in monitoring vaccine utilization, adverse event reporting, and community feedback to refine service delivery. This integrated approach aims to create a responsive, locally informed procurement system that complements national immunization efforts and reinforces comprehensive disease prevention across provinces, districts, and subdistricts.
Vaccines Approved for Local Administrative Organization Procurement
The National Vaccine Committee has authorized two vaccines for LAO procurement, recognizing the specific protective needs of local populations and the practicalities of local health delivery. The first vaccine is an influenza vaccine designated for at-risk groups. The second is the pneumococcal conjugate vaccine (PCV), which is intended for children under the age of five. These choices reflect a targeted strategy to address seasonal influenza dynamics and the burden of pneumococcal disease among young children, both of which substantially contribute to severe illness and healthcare utilization in vulnerable populations. The influenza vaccine for at-risk groups is prioritized to reduce the incidence and severity of influenza infections among those most susceptible to complications, such as older adults, individuals with chronic diseases, pregnant women, and other high-risk individuals identified by local health authorities. The PCV for children under five targets a key early-life protection window, aiming to prevent pneumococcal pneumonia, meningitis, and other invasive pneumococcal diseases that disproportionately affect infants and toddlers. By enabling LAOs to procure these vaccines, the policy seeks to broaden local immunity, strengthen protection during critical periods, and complement the core immunization schedule administered through national channels. Procurement processes are expected to adhere to established safety, storage, and distribution standards, ensuring that vaccines remain effective, safe, and accessible to eligible populations within local jurisdictions. The framework also outlines monitoring and reporting requirements so vaccination outcomes can be tracked, evaluated, and integrated into a broader evidence base for future decision-making and policy refinement.
Influenza: Seasonality, Timing, and Local Vaccination Strategy
Influenza remains a recurring public health challenge, with activity persisting throughout the year and escalating during specific climatic periods. While influenza transmission is year-round, peak activity often aligns with rainy and cooler seasons, leading to spikes in illness, hospitalizations, and, in some cases, mortality. A key strategic element of the LAO procurement initiative is to optimize vaccination timing so that at-risk groups achieve protective immunity before these high-activity windows. In practical terms, this means prioritizing vaccination campaigns that commence ahead of the anticipated peak period, with emphasis on months that historically precede or precede the rainy-season surge. The policy promotes proactive scheduling to ensure that individuals who are most vulnerable receive protection in a timely manner, thereby reducing the likelihood of severe disease and healthcare system strain during peak periods. Local vaccination strategies will be tailored to regional epidemiology, seasonality patterns, and service delivery capacities, enabling LAOs to coordinate with health facilities to implement targeted outreach campaigns, community education, and convenient access points for vaccination.
The influenza vaccination strategy for LAOs is designed to be adaptable across provinces, taking into account local infrastructure, workforce availability, and community needs. By leveraging LAO networks, local campaigns can be synchronized with school calendars, workplace vaccination programs, and community events to maximize reach and uptake. In addition to vaccination clinics, outreach through mobile services, community health volunteers, and partner organizations can expand access to hard-to-reach populations. The approach emphasizes equity, ensuring that disadvantaged groups, including migrants and rural residents with limited access to health services, receive appropriate vaccination opportunities. By coordinating with provincial health authorities and the broader health system, LAOs can align their influenza vaccination activities with other respiratory illness prevention efforts, such as health promotion campaigns and infection control measures. The expected impact is a reduction in severe influenza cases, lower hospitalization rates, and improved resilience of communities during seasonal surges, while contributing to a more efficient use of healthcare resources.
Case studies from pilot provinces illustrate practical benefits of timely influenza vaccination at the local level. In these pilots, LAOs coordinated with local health partners to implement targeted vaccination drives, establish accessible vaccination points, and engage communities through culturally appropriate outreach. The pilots provided valuable lessons on logistics, demand forecasting, stakeholder coordination, and the importance of sustaining vaccination coverage beyond initial campaigns. While the pilots demonstrated positive responses and increased local engagement, they also highlighted challenges, such as ensuring consistent vaccine supply, maintaining cold-chain integrity in remote areas, and addressing vaccine hesitancy through clear communication strategies. Overall, the influenza vaccination component of the LAO procurement policy is designed to create a scalable, locally responsive mechanism for protecting at-risk groups against seasonal influenza and its complications, while laying a foundation for broader immunization gains in conjunction with other vaccines.
Pneumococcal Conjugate Vaccine (PCV): Target Groups and Health Impact
The pneumococcal conjugate vaccine (PCV) targets a critical subset of the population—children under five—who are particularly vulnerable to pneumococcal infections that can manifest as pneumonia, meningitis, and other serious illnesses. Pneumococcal disease presents a major health threat to young children, and severe cases exhibit seasonal variation similar to influenza, with higher burdens during certain times of the year. In addition to the direct protection of children, PCV vaccination contributes to herd immunity, reducing transmission within communities and delivering broader public health benefits. The policy recognizes that high-risk groups extend beyond young children and include older adults (over 65), individuals who are immunocompromised, and those with chronic health conditions. For these groups, the interplay of pneumococcal disease burden and comorbidities reinforces the importance of robust vaccination strategies that integrate with other preventive health measures. LAOs delivering PCV can play a pivotal role by ensuring timely access for eligible children, coordinating with pediatric care providers, and facilitating outreach to families with barriers to vaccination.
Operationally, PCV procurement by LAOs requires careful consideration of cold-chain requirements, storage capacity, and distribution logistics to maintain vaccine potency and safety. Local teams must work closely with vaccination sites to ensure that schedules for dose administration are aligned with clinical guidelines, that follow-up doses are tracked, and that adverse events are monitored and reported promptly according to national safety standards. The PCV program’s success hinges on effective communication with caregivers about the benefits of vaccination, addressing concerns, and providing clear information about the immunization schedule. By integrating PCV procurement with broader immunization efforts, LAOs can reinforce the protection of young children during critical periods of growth and development, reduce pneumococcal disease burden, and contribute to the long-term health resilience of their communities. The policy encourages ongoing evaluation to measure vaccination coverage, disease incidence, and health outcomes, feeding this data into continuous improvement cycles for the local vaccination program.
Pilot Programs and Early Outcomes
Pilot programs in select provinces have tested the feasibility and impact of LAOs taking an active role in vaccine procurement for the influenza vaccine and PCV. These pilots demonstrated the practical viability of decentralized procurement, showcasing how LAOs can coordinate with provincial health offices, local hospitals, and community networks to deliver vaccines more efficiently and responsively. Early outcomes indicated improvements in access to vaccines, with communities reporting greater convenience, reduced wait times, and expanded outreach to vulnerable groups. The pilots also highlighted the value of close collaboration with subdistrict health promoting hospitals and other local health facilities, which provided essential clinical support, vaccination services, and data for monitoring progress. Importantly, pilot findings emphasized the necessity of robust cold-chain management, reliable supply chains, and clear communication strategies to sustain vaccination coverage over time. The experiences underscored the importance of local leadership, stakeholder engagement, and transparent governance in achieving successful procurement and immunization outcomes. While the pilots offered promising indicators, they also surfaced challenges that informed the refinement of guidelines, training programs, and coordination mechanisms to ensure scalability and consistency as the policy expands. Overall, early results from these pilots validate the concept that empowered LAOs can contribute meaningfully to local vaccine access, while providing practical insights for broader implementation.
Building a Robust Vaccine Network Across Regions
As the policy advances, the emphasis shifts to building a strong, collaborative vaccine network that spans provinces and regions. This network is designed to harmonize procurement standards, share best practices, and coordinate supply planning to prevent regional disparities in vaccine access. The approach centers on strengthening the connections between LAOs, PPHOs, SHPHs, and other health system components, creating a cohesive continuum from procurement to administration. A regionalized network enables the pooling of demand, optimizing procurement scale, and enabling more predictable vaccine supply. It also supports the alignment of vaccination campaigns with regional epidemiology, climate patterns, and local health priorities, ensuring that initiatives are both timely and contextually appropriate. The network fosters cross-jurisdictional learning, allowing provinces with more experience in LAO-led procurement to share lessons and tools with others that are newer to the approach. In addition, it promotes coordinated communications strategies to maintain public confidence in vaccination programs and to address local concerns and questions. A well-functioning regional network requires robust governance structures, standardized procedures, and transparent reporting that enable continuous quality improvement across all participating local authorities. By cultivating this collaborative ecosystem, the policy aims to create sustainable, scalable mechanisms for vaccine access that strengthen Thailand’s overall disease prevention infrastructure.
Implementation Roadmap: Capacity Building, Procedures, and Compliance
A detailed implementation roadmap guides LAOs through the procurement and delivery process for the approved vaccines. The plan emphasizes building procurement capacity at the local level, including staff training in forecasting, tendering, supplier management, contract enforcement, and post-procurement analysis. It also prioritizes strengthening supply chain management, with a focus on cold-chain integrity, storage conditions, and timely distribution to vaccination sites. The roadmap outlines clear procedures for demand planning, budgeting, and resource allocation to ensure that LAOs can secure vaccines in line with local needs while adhering to national safety and quality standards. It also delineates roles and responsibilities across the governance architecture, clarifying accountability lines and reporting requirements. Data readiness is a central component, with guidance on how to collect, manage, and analyze vaccination data, coverage rates, adverse event reporting, and program outcomes. The implementation strategy includes phased rollouts, pilot expansions, and milestones for evaluating progress, allowing for iterative refinements based on field experiences. Training programs, materials, and technical support are to be provided to LAOs to facilitate skill development, compliance, and continuous improvement. The overall objective is to create a reliable, transparent, and durable mechanism for LAOs to procure and deliver vaccines effectively, ensuring that local populations receive timely protection and that the broader immunization program remains coherent and high-performing.
Challenges, Risks, and Mitigation Strategies
The shift to local vaccine procurement introduces a set of challenges that require proactive planning and adaptive management. Potential obstacles include funding limitations, supply variability, and disruptions to the cold chain that could compromise vaccine potency. There is also the risk of inequities in access if procurement and distribution are not carefully planned to reach underserved communities, rural residents, and marginalized groups. Human resources constraints, including a shortage of trained personnel for procurement, logistics, and immunization service delivery, may affect rollout speed and effectiveness. Additionally, vaccine confidence and hesitancy can influence uptake, particularly in communities with limited exposure to immunization campaigns or with misinformation circulating in local networks. Mitigation strategies focus on establishing stable funding mechanisms, creating contingency stockpiles, and developing diversified supply routes to reduce vulnerability to supplier interruptions. Strengthening the cold-chain infrastructure, investing in digital inventory management systems, and implementing standardized operating procedures help maintain vaccine quality and reliability. Community engagement and transparent communication are essential to addressing hesitancy, leveraging trusted local figures, and providing clear, culturally appropriate information about vaccine benefits, risks, and the immunization schedule. Ongoing training and capacity-building programs are critical to maintaining a competent workforce and ensuring adherence to safety and quality standards. A proactive risk management approach, with regular reviews and adaptive planning, will be essential to navigate evolving challenges and to sustain progress toward broader vaccine access.
Public Health Impact and Equity Considerations
Expanding LAO involvement in vaccine procurement has meaningful implications for public health, particularly for vulnerable populations. By facilitating easier access to vaccines such as influenza vaccines for at-risk groups and PCV for young children, the program supports reductions in preventable illness, hospitalizations, and associated health system burdens. Local procurement emphasizes equity by directing resources to communities that historically face barriers to vaccination, improving access for rural residents, underserved urban populations, and households with lower health literacy. The approach also reinforces the protection of older adults and individuals with chronic conditions, who are disproportionately affected by vaccine-preventable diseases. In strengthening local health governance and community engagement, the policy enhances resilience against disease outbreaks and seasonal health fluctuations. The resulting health gains extend beyond individual protection to broader community well-being, reducing transmission, protecting school-age children, supporting parents and caregivers, and contributing to healthier, more productive communities. The LAO strategy also fosters a culture of prevention by integrating vaccination into broader local health initiatives, enabling more holistic approaches to protecting public health and promoting long-term health equity.
Conclusion
The National Vaccine Institute, in collaboration with the Department of Disease Control, is charting a path toward empowered local governance in vaccine procurement. By authorizing Local Administrative Organizations to procure specific vaccines—influenza for at-risk groups and PCV for children under five—the policy foregrounds local leadership, community engagement, and cross-sector collaboration as essential drivers of expanded vaccine access. LAOs, positioned at the heart of communities and connected to health facilities and regional authorities, are well-placed to tailor procurement and delivery to local needs while maintaining alignment with national safety and quality standards. The initiative builds on the strength of partnerships with Provincial Health Offices and Subdistrict Health Promoting Hospitals to broaden vaccination coverage, reduce the burden of vaccine-preventable diseases, and strengthen Thailand’s disease prevention infrastructure. Early pilots have demonstrated the practicality and potential impact of local procurement, providing valuable lessons for scaling the approach across regions. As the policy moves into broader implementation in the coming period, the emphasis remains on capacity building, transparent governance, robust supply chains, and continuous evaluation to ensure sustainable, equitable vaccine access for all communities. By fostering an integrated, locally informed procurement network, this program seeks to enhance public health outcomes, resilience, and the overall effectiveness of Thailand’s immunization efforts.