In summary, our findings suggest that seasonal influenza vaccination of children with LAIV
is likely to represent good value for money in the Thai setting and potentially in many other developing
economies. Fundamental uncertainties about influenza remain, however, and for this
reason we believe proposals for large-scale community-based controlled trials of policies to vaccinate
children against influenza are as relevant to low- and middle-income settings as they are
to high-income countries [3]. The results of the present study were used to inform the development
of the Health Promotion and Disease Prevention Benefit Package under the universal
health coverage in Thailand. It was proposed that a school-based seasonal influenza vaccination
program should be piloted in a few selected provinces in fiscal year 2016 before considering
scale-up to a nationwide program. The design and evaluation of such pilot studies will need
careful consideration, but prospective community-based household cohort studies in vaccinated
and unvaccinated populations may be particularly valuable as part of this work