Pakistan becomes first country to introduce typhoid conjugate vaccine

ISLAMABAD: Pakistan has become the world's first country to introduce the typhoid conjugate vaccine (TCV) into its routine immunisation programme through a campaign in Sindh.

According to a press release issued Friday, the government is launching the vaccine with a campaign in Sindh province in a response to an outbreak of typhoid since November 2016.

The launching ceremony of the Typhoid vaccine introduction, held in a local Karachi hotel, was presided by Prime Minister Imran Khan's special assistant on health, Dr Zafar Mirza, and Sindh Health Minister Dr Azra Fazal Pechuho.

Officials of the Ministry of National Health Services, Regulations and Coordination, and Sindh Health Department — including Director-General (DG) Health, Expanded Program on Immunization (EPI) National Program Manager, National Emergency Operation Centre (EOC) Coordinator, DG  Health for Sindh, and EPI Sindh Director — also participated.

In this regard, Dr Mirza, the PM's special assistant, said: “Children are disproportionately affected by typhoid and its associated complications, and we strongly believe that TCV would protect our children against potentially fatal disease of Typhoid, starting with Sindh Province, where the need is most urgent, the government of Pakistan has planned a phased national introduction strategy with strong, coordinated support from global and local partners.”

In 2017, 63 percent of typhoid cases and 70 percent of typhoid deaths in Pakistan were among children younger than 15 years of age.

To prevent these deaths, the phased introduction will begin with a two-week campaign targeting 10.1 million children nine months to 15 years of age in over 460 urban union councils of Sindh, with the funding support from Gavi, the Vaccine Alliance. This will include 4.7 million children from Karachi.

As the campaign needs to reach older children, schools will play a major role.

Following the campaign, the vaccine will be given to nine-month old infants as part of routine immunisation at EPI centres in all parts of the province.

“Typhoid is a highly contagious disease that spreads more quickly and easily when people live in crowded neighbourhoods with weak water and sanitation infrastructure," said Dr Pechuho, the health minister for Sindh.

"Beginning the vaccination in urban areas is critical in preventing the disease among the communities most at risk. Prevention through vaccination is one of the most effective interventions to reduce typhoid infections."

The TCV campaign will be conducted from November 18-30 in Sindh and will be followed by TCV being a part of the Routine Immunization Programme in December. The government is also promoting WASH solutions (water, sanitation, and hygiene) alongside TCV introduction.

TCV is a one-dose vaccine, injected intramuscularly — that is lower cost, has higher efficacy, and is expected to provide long lasting immunity in adults, children, and infants older than nine months of age.

The United Nations Children's Fund's (UNICEF) representative in Pakistan, Aida Girma, said: “We applaud the Government of Pakistan for prioritising immunisation of children at risk of typhoid. Their phased national introduction plan for TCV will ensure that the vaccine will reach the children most at risk first."

The chief executive officer (CEO) of Gavi, the Vaccine Alliance, Dr Seth Berkley, said: “Before the discovery of antibiotics, typhoid would kill as many as one in five people who contracted it. The rise of extreme drug resistant typhoid risks bringing us back to levels of mortality not seen since the 19th century, posing a risk to all of us.

"That’s why typhoid conjugate vaccine is so important and why the government of Pakistan deserves praise for being the first to introduce this lifesaver into its routine immunisation programme.