Adverse events following immunization with typhoid conjugate vaccine in an outbreak setting in Hyderabad, Pakistan

Qamar, Farah Naz; Yousafzai, Mohammad Tahir; Khaliq, Asif; Karim, S. M. M.; Memon, Hina; Junejo, Amber; Baig, Inayat; Rahman, Najeeb; Bhurgry, Shafqat; Afroz, Hina; Sami, Uzma

doi:10.1016/j.vaccine.2020.03.028

Cited by 24 publications

(24 citation statements)

References 17 publications

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“…The need for booster injections with TCV is unresolved. In 2018, Pakistan recently used the TCV vaccine in children aged 9 months to 15 years in an effort to control the outbreak of extensively drug resistant typhoid in Sindh province 46. Further trials of this and other typhoid conjugate vaccines are in progress.…”

Section: How Can Enteric Fever Be Prevented?mentioning

confidence: 99%

Enteric fever

Basnyat

Qamar

Rupali

et al. 2021

BMJ

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Section: How Can Enteric Fever Be Prevented?mentioning

confidence: 99%

Enteric fever

Basnyat

Qamar

Rupali

et al. 2021

BMJ

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“…Overall, TCVs have been shown to have a reassuringly safety profile across age groups including infants and children [ 13 , 14 , 15 , 16 , 17 ]. An individually randomized trial of Vi-TT in Nepal, conducted by the Typhoid Vaccine Acceleration Consortium (TyVAC) led by the University of Maryland in partnership with the University of Oxford and PATH, determined the vaccine efficacy to be 81.6% (95% confidence interval, between 58.8% and 91.8%), while another trial in Malawi is expected to provide estimates of efficacy within this year [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Typhoid Conjugate Vaccine Effectiveness in Ghana (TyVEGHA) Using a Cluster-Randomized Controlled Phase IV Trial: Trial Design and Population Baseline Characteristics

et al. 2021

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Typhoid fever remains a significant health problem in sub-Saharan Africa, with incidence rates of >100 cases per 100,000 person-years of observation. Despite the prequalification of safe and effective typhoid conjugate vaccines (TCV), some uncertainties remain around future demand. Real-life effectiveness data, which inform public health programs on the impact of TCVs in reducing typhoid-related mortality and morbidity, from an African setting may help encourage the introduction of TCVs in high-burden settings. Here, we describe a cluster-randomized trial to investigate population-level protection of TYPBAR-TCV®, a Vi-polysaccharide conjugated to a tetanus-toxoid protein carrier (Vi-TT) against blood-culture-confirmed typhoid fever, and the synthesis of health economic evidence to inform policy decisions. A total of 80 geographically distinct clusters are delineated within the Agogo district of the Asante Akim region in Ghana. Clusters are randomized to the intervention arm receiving Vi-TT or a control arm receiving the meningococcal A conjugate vaccine. The primary study endpoint is the total protection of Vi-TT against blood-culture-confirmed typhoid fever. Total, direct, and indirect protection are measured as secondary outcomes. Blood-culture-based enhanced surveillance enables the estimation of incidence rates in the intervention and control clusters. Evaluation of the real-world impact of TCVs and evidence synthesis improve the uptake of prequalified/licensed safe and effective typhoid vaccines in public health programs of high burden settings. This trial is registered at the Pan African Clinical Trial Registry, accessible at Pan African Clinical Trials Registry (ID: PACTR202011804563392).

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“…In 2017, the World Health Organization pre-qualified the typhoid conjugate vaccine, Typbar TCV® (Bharat Biotech International Limited, Hyderabad, India), recommending that introduction of TCV should be prioritized in settings with a high burden of typhoid illness or drug-resistant strains [ 10 ]. Thereafter, the vaccine was first used as part of the response to the rapidly spreading XDR typhoid outbreak in Hyderabad, Pakistan in February 2018, in which Aga Khan University Hospital (AKUH) successfully administered 207,000 doses of Typbar TCV during a mass immunization campaign [ 11 ]. Building upon this success, in April 2019 AKUH began a mass immunization campaign in Lyari Town, Karachi, where large numbers of XDR typhoid cases were reported.…”

Section: Introductionmentioning

confidence: 99%

“…Typhoid fever most commonly affects children, with 90% of XDR typhoid fever cases in Karachi occurring among children <15 years of age [ 11 ]. We started a vaccination campaign aimed to vaccinate 80,000 children between 6 months and 15 years of age with Typbar TCV (intramuscularly as a single 0.5 mL dose) in Lyari Town, Karachi.…”

Section: Introductionmentioning

confidence: 99%

Strategies to Improve Coverage of Typhoid Conjugate Vaccine (TCV) Immunization Campaign in Karachi, Pakistan

et al. 2020

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The emergence and spread of extensively drug-resistant (XDR) typhoid in Karachi, Pakistan led to an outbreak response in Lyari Town, Karachi utilizing a mass immunization campaign with typhoid conjugate vaccine (TCV), Typbar TCV®. The mass immunization campaign, targeted Lyari Town, Karachi, one of the worst affected towns during the XDR typhoid outbreak. Here we describe the strategies used to improve acceptance and coverage of Typbar TCV in Lyari Town, Karachi. The mass immunization campaign with Typbar TCV was started as a school- and hospital-based vaccination campaign targeting children between the age of 6 months to 15 years old. A dose of 0.5 mL Typbar TCV was administered intramuscularly. A mobile vaccination campaign was added to cope with high absenteeism and non-response from parents in schools and to cover children out of school. Different strategies were found to be effective in increasing the vaccination coverage and in tackling vaccine hesitancy. Community engagement was the most successful strategy to overcome refusals and helped to gain trust in the newly introduced vaccine. Community announcements and playing typhoid jingles helped to increase awareness regarding the ongoing typhoid outbreak. Mop-up activity in schools was helpful in increasing coverage. Networking with locally active groups, clubs and community workers were found to be the key factors in decreasing refusals.

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Adverse events following immunization with typhoid conjugate vaccine in an outbreak setting in Hyderabad, Pakistan

Cited by 24 publications

References 17 publications

Enteric fever

Enteric fever

Evaluation of Typhoid Conjugate Vaccine Effectiveness in Ghana (TyVEGHA) Using a Cluster-Randomized Controlled Phase IV Trial: Trial Design and Population Baseline Characteristics

Strategies to Improve Coverage of Typhoid Conjugate Vaccine (TCV) Immunization Campaign in Karachi, Pakistan

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