Typhoid vaccine introduction: An evidence-based pilot implementation project in Nepal and Pakistan.
The World Health Organization (WHO) in 2008 recommended the use of currently licensed typhoid vaccines using a high risk or targeted approach. The epidemiology of disease and the vaccine characteristics make school-based vaccination most feasible in reducing typhoid disease burden in many settings. To assess feasibility of school-based typhoid vaccination, two districts in Kathmandu, Nepal and two towns in Karachi, Pakistan were selected for pilot program. Vaccination campaigns were conducted through the departments of health and in partnerships with not-for-profit organizations. In total 257,015 doses of Vi polysaccharide vaccine were given to students in grades 1-10 of participating schools. The vaccination coverage ranged from 39 percent (38,389/99,503) in Gulshan town in Karachi, to 81 percent (62,615/77,341) in Bhaktapur in Kathmandu valley. No serious adverse event was reported post vaccination. The coverage increased for vaccination of the second district in Pakistan as well as in Nepal. There was an initial concern of vaccine safety. However, as the campaign progressed, parents were more comfortable with vaccinating their children in schools. Supported and conducted by departments of health in Pakistan and Nepal, a school-based typhoid vaccination was found to be safe and feasible.
International Vaccine Institute, Seoul, Republic of Korea. Electronic address: khan.m.imran@outlook.com.
M Imran
MI
Khan
International Vaccine Institute, Seoul, Republic of Korea.
Alfred
A
Pach
Trust for Vaccines & Immunization, Karachi, Pakistan.
Ghulam Mustafa
GM
Khan
Group for Technical Assistance, Sanepa, Nepal.
Deepak
D
Bajracharya
International Vaccine Institute, Seoul, Republic of Korea.
Sushant
S
Sahastrabuddhe
Trust for Vaccines & Immunization, Karachi, Pakistan.
Waqaas
W
Bhutta
Trust for Vaccines & Immunization, Karachi, Pakistan.
Rehman
R
Tahir
Aga Khan University, Karachi, Pakistan.
Sajid
S
Soofi
Group for Technical Assistance, Sanepa, Nepal.
Chandra B
CB
Thapa
MITRA Samaj, Kathmandu, Nepal.
Nilesh
N
Joshi
International Vaccine Institute, Seoul, Republic of Korea.
Mahesh K
MK
Puri
Group for Technical Assistance, Sanepa, Nepal.
Parisha
P
Shrestha
Ministry of Health and Population, Government of Nepal, Nepal.
Shyam Raj
SR
Upreti
International Vaccine Institute, Seoul, Republic of Korea.
John D
JD
Clemens
Aga Khan University, Karachi, Pakistan.
Zulfiqar
Z
Bhutta
International Vaccine Institute, Seoul, Republic of Korea.
R Leon
RL
Ochiai
D002648:Child; D006801:Humans; D009390:Nepal / Q000453:epidemiology; D010154:Pakistan / Q000453:epidemiology; D010290:Parents / Q000523:psychology; D061214:Patient Safety; D010865:Pilot Projects; D012572:School Health Services; D013334:Students; D014435:Typhoid Fever / Q000453:epidemiology / Q000517:prevention & control*; D014436:Typhoid-Paratyphoid Vaccines / Q000008:administration & dosage* / Q000276:immunology; D014611:Vaccination; D055815:Young Adult
D014436:Typhoid-Paratyphoid Vaccines
Asia; Enteric fever; Nepal; Pakistan; Typhoid; Vaccination campaign; Vi polysaccharides vaccine