Typhoid vaccine

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More than 11 million people are infected with typhoid every year, mainly in developing countries.

Typhoid fever

Typhoid fever affects more than 11 million people every year, mainly in sub-Saharan Africa and South Asia. Almost a third of all cases are among young children. Credit: Gavi/2016/Kate Holt.

Typhoid fever is a life-threatening disease caused by the bacterium Salmonella Typhi. It is mainly transmitted through contaminated food or water. Symptoms include prolonged fever, headache, nausea, loss of appetite, constipation and sometimes diarrhoea. If typhoid is not treated, it can kill up to 30% of those who are infected.

Disease burden

While improvements in living conditions and increased access to antibiotics have largely eliminated typhoid from industrialised countries, it remains a serious threat in developing countries.

Typhoid affects 11-21 million people each year, causing 128,000 to 161,000 deaths - mainly in sub-Saharan Africa and South Asia. Almost a third of all cases are among children under five, highlighting the importance of being able to prevent the disease in young children.

Antibiotic resistance

With appropriate antibiotic treatment, the case fatality rate of typhoid can drop to less than 1%. However, in recent years there has been an alarming increase in antimicrobial resistance of Salmonella Typhi. Drug-resistance is spreading across Asia and Africa, posing a serious threat to public health.

This could stall efforts to control the disease and force a shift of focus towards prevention rather than cure, mainly through immunisation and improved access to safe water, sanitation and hygiene.

Vaccine-preventable

Typhoid conjugate vaccines, in combination with increased access to improved sanitation and clean water, can significantly reduce the spread and burden of typhoid fever around the world.

In October 2017, WHO recommended the introduction of typhoid vaccine for children over six months in endemic countries. It also recommended catch-up vaccination whenever possible, prioritising children and adolescents up to 15 years of age.

  

Gavi opened a funding window for typhoid conjugate vaccine in November 2017.

Gavi prioritised typhoid vaccines in 2008, as part of the vaccine investment strategy, but did not make a financial commitment due to the absence of a suitable vaccine. Following the WHO prequalification of a new typhoid vaccine at the end of 2017, we opened a funding window for the vaccine.

This was shortly after WHO’s Strategic Advisory Group of Experts on Immunization recommended that all endemic countries introduce typhoid vaccine into their routine immunisation systems.

Investing in typhoid vaccines is closely aligned with Gavi’s mission and strategic goals.

  • Almost a third of all cases are among children under five years of age.
  • While high-income countries have virtually eliminated typhoid, it still common in developing countries. Typhoid vaccines can help bridge this equity gap.
  • Through our market shaping efforts, we can help to improve supply of the vaccine and encourage new manufacturers to enter the market – increasing healthy competition.

More effective vaccine

Previous typhoid vaccines were not effective in children younger than two years, and only provided short-term protection. The new conjugate vaccine promotes a stronger immune response. As a result, it provides long-term protection and can be effective in children as young as six months.

High routine immunisation coverage with the new typhoid vaccine can play an important role in controlling this deadly disease. The use of the vaccine will also help the global community to understand its impact on antimicrobial resistance, as well as to identify appropriate immunisation strategies.

Gavi support

In line with WHO recommendations, Gavi supports catch-up campaigns and co-finances the vaccine for use in routine immunisation programmes. We fund the vaccine itself, as well as injection supplies and a grant to cover introduction costs. 

The first country applications were submitted in early 2018, with introductions expected to start in the first half of 2019.

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