Typhoid vaccine approved in Pakistan

By Abdul Qadir Qureshi
(Pakistan News & Features Services)

A new typhoid conjugate vaccine is to be added to the National Expanded Programme for Immunization following new evidence about the threat posed by a strain of typhoid that is extremely difficult to treat with antibiotics.

An outbreak of extensively-drug resistant (XDR) typhoid in Hyderabad has already affected many children. The research from Aga Khan University (AKU), presented at the National Immunization Technical Advisory Group meeting in Islamabad, shows that cases are now appearing in Karachi, rural areas on the outskirts of Sindh, as well as in Quetta and parts of Khyber Pakhtunkhwa. 

The results of an emergency vaccination campaign launched by the Sindh health department in the worst-affected talukas of Hyderabad in January 2018 were also presented. The data showed that the typhoid conjugate vaccine was safe with no adverse events being noted in 99.7 per cent of children who received doses. 

The Ministry of National Health Services Regulations and Coordination will now submit an application to GAVI, a global, public-private partnership committed to increasing access to immunization, to seek funding for the vaccination.

“The recent GAVI commitment of US$ 85 million in funding to support the introduction of typhoid conjugate vaccines is a great opportunity for Pakistan. We have previously introduced vaccines against pneumonia, diarrhea and the injectable polio vaccine. The launch of the typhoid vaccine will be another step towards improving the immunity of our children against disease,” Dr Syed Saqlain Ahmad Gilani, national programme manager for the federal Expanded Programme for Immunization (EPI), stated. 

With this addition, the EPI would vaccinate children against 10 deadly diseases like diphtheria, hepatitis B, meningitis, measles, childhood tuberculosis, tetanus, pneumonia, whooping cough, polio and now typhoid. 

“We are running out of medicines that can treat typhoid as the new XDR strain is resistant to five classes of antibiotics. Immunization is the only feasible option we have left against this superbug and since this vaccine has been demonstrated to be safe, we now need to intensify our efforts to bring it to every child in Pakistan,” Farah Qamar, associate professor of paediatrics at AKU, explained. 

Over 1,000 cases of XDR typhoid have been noted in Hyderabad and Karachi since 2016; this is alarming since only six cases of drug-resistant typhoid were found in the whole of Pakistan over a five-year period between 2009 and 2014. 

 Dr Anita Zaidi, Director of Vaccine Development, Surveillance, and Enteric and Diarrheal Diseases at the Bill and Melinda Gates Foundation, and an AKU alumna, was also involved in global efforts to generate evidence of the efficacy for this vaccine against typhoid fever. 

“For too long, typhoid, which invariably affects the world’s poorest people, has been neglected in efforts to improve global health. With this new vaccine, the first-ever to be useful for preventing typhoid in young children countries, will finally be able to protect millions of children who are most vulnerable to this deadly disease,” she observed.

The research and advocacy efforts were backed by a team at AKU including Professor Rumina Hasan, Professor Zahra Hasan and Dr Sadia Shakoor from the department of pathology and microbiology, Dr Farah Qamar, Dr Tahir Yousafzai and Dr Momin Kazi from the department of paediatrics and child health at AKU. 

The control and prevention of water-borne diseases such as typhoid is a global health priority with targets under goal 3 of the Sustainable Development Goals calling for the eradication of such diseases by 2030.