Latest articles about typhoid       Routine vaccines: Typhoid

Gavi's impact

Approximately 40 million children have been reached with TCV with Gavi support


Gavi funding for WHO-prequalified typhoid conjugate vaccine (TCV) became available in 2018. In 2019, Pakistan became the first country to introduce the new TCV into its routine immunisation programme, using a phased approach; Liberia and Zimbabwe introduced nationwide in 2021; and Nepal in 2022. By end 2021, more than 3 million children had been reached with TCV through routine immunisation, and an additional 36 million children aged up to 15 through catch-up campaigns, implemented with Gavi support alongside routine introduction.


While the COVID-19 pandemic initially slowed the pace of new TCV introductions, a growing body of evidence of the vaccine's high efficacy, the threat of antibiotic resistant strains of Salmonella Typhi and data-driven efforts to support country decision-making using available typhoid burden data have helped generate renewed momentum: three additional countries are planning their introductions; and others, including India, have National Immunization Technical Advisory Group (NITAG) recommendations for introduction. The Vaccine Alliance will continue supporting high-burden countries to introduce TCV – including by helping to strengthen disease diagnostic testing and surveillance, in order to assess disease burden and guide decision-making for impactful vaccine use.

Rolling out TCV in Pakistan

The issue

Every year, 11–20 million people are infected with typhoid, mainly in low-income countries.

Typhoid fever is a life-threatening disease mainly transmitted through contaminated food or water by the bacterium Salmonella Typhi. Symptoms include prolonged fever, headache, nausea, loss of appetite, constipation and sometimes diarrhoea.

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 (AMR) of Salmonella Typhi. Drug-resistance is spreading across Asia and Africa, posing a serious threat to public health. AMR is increasingly complicating typhoid fever case management, increasing the risk of complications and death, and burdening families and health care systems.


Just one dose of TCV protects against typhoid fever, and is highly effective in children as young as six months of age. TCV available through Gavi support a stronger immune response, resulting in a longer duration of immunity and better protection in children than previous typhoid vaccines. Routine use of TCV in national immunisation programmes, in combination with increased access to safe water, sanitation and hygiene, is key to preventing infection and reducing the spread and burden of typhoid around the world (including resistant strains).

In October 2017, the World Health Organization (WHO) recommended the introduction of TCV for children aged over six months in endemic countries and aligned with the existing routine immunisation schedule where possible. It also recommended catch-up vaccination when feasible and appropriate, prioritising children aged up to 15 years, in order for the introduction to have the greatest impact by quickly reducing disease transmission.

Gavi’s response

Gavi prioritised TCV in 2008, as part of its Vaccine Investment Strategy, but did not make a financial commitment due to the absence of a suitable vaccine. Following the WHO prequalification of a newly available conjugated typhoid vaccine at the end of 2017, and the release of WHO Strategic Advisory Group of Experts on Immunization (SAGE) guidance on the use of TCV, Gavi opened a funding window for countries to apply for the vaccine.

More on applying for TCV support

Gavi prioritised TCV in 2008, as part of its Vaccine Investment Strategy, but did not make a financial commitment due to the absence of a suitable vaccine. Following the WHO prequalification of a newly available conjugated typhoid vaccine at the end of 2017, and the release of WHO Strategic Advisory Group of Experts on Immunization (SAGE) guidance on the use of TCV, Gavi opened a funding window for countries to apply for the vaccine.

More on applying for TCV support


  • The majority of cases are among children aged under 15 years.
  • While high-income countries have virtually eliminated typhoid, it is still common in low-income countries, particularly affecting communities who face multiple deprivations – including lack of access to quality water, sanitation and health services. TCV 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 competition and improving healthy market dynamics.


In line with WHO recommendations, Gavi provides: co-financing support for nationwide introduction of TCV into the routine immunisation programme; and full financing for a one-time catch-up immunisation campaign for children aged up to 15 years based on local typhoid epidemiology. Funding support includes vaccines, vaccination supplies and operational costs for implementation.  

Latest articles about typhoid

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New TCV data from Malawi highlight longer-term immune response

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‘Global response’ needed as typhoid evades antibiotics

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Celebrating Nepal’s typhoid conjugate vaccine introduction

The introduction of typhoid conjugate vaccine in Nepal is a great step forward in keeping children healthy and protected from typhoid.

Now we know: typhoid conjugate vaccines are highly effective in African children

A study in Malawi found that TCVs are 84% efficacious among children 6 months to 15 years of age – the first such evidence among African children.

TCV is 85% efficacious and urgently needed for Bangladeshi children

New study finds TCV prevents 85% of cases among vaccinated children in Bangladesh, which has one of the highest typhoid burdens in the world.

The tragedy of Typhoid Mary

Mary Mallon was branded a public menace and incarcerated after typhoid outbreaks across New York City were linked to her presence in the kitchen. Was she unfairly demonised?

Tackling typhoid in Zimbabwe: “We have to be sure for ourselves that the water is safe”

After a devastating typhoid outbreak swept through Bulawayo, Zimbabwe, a new, more effective vaccine is bringing hope.

The next step: Lifesaving typhoid conjugate vaccines reach Punjab province, Pakistan

Punjab province introduces typhoid conjugate vaccine, taking the next step in protecting children from typhoid in Pakistan.

More typhoid conjugate vaccines, more impact

A second typhoid conjugate vaccine has achieved WHO prequalification and others are in development. More vaccines will help increase access to TCVs.

One step closer to untreatable typhoid

The continued emergence and spread of drug-resistant typhoid make infections more difficult to treat. Life-saving vaccines are urgently needed to prevent it and to limit its spread.

Keep focus on emerging infections, Disease X: analysts

Biggest funders of emerging infectious diseases R&D are also biggest recipients. Ebola and Zika experienced R&D spike in wake of epidemics. US is losing global leadership role in the field.

Typhoid: immunising against antimicrobial resistance

Typhoid fever is increasingly resistant to the main antibiotics used to treat it. Gavi is supporting a new vaccine to help control this deadly disease – and fight antimicrobial resistance.

Last updated: 16 Jan 2023

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