An Effective Alternative to Injections

The typhoid fever, a bacterial infection caused by Salmonella Typhi, remains a major public health problem in many developing countries where sanitation and clean water supplies are limited. Every year over 11 million cases of typhoid fever occur globally resulting in over 128,000 deaths. Children and young adults are at highest risk. The disease is effectively treated with antibiotics but antibiotic resistance is growing. An oral vaccine can help reduce the burden of the disease worldwide.

A Safe and Effective Option

The recently WHO prequalified live attenuated oral typhoid vaccine called Typbar-TCV was developed by Bharat Biotech of India. It contains a live but weakened strain of Salmonella Typhi which does not cause disease but triggers strong immune response in the body. In clinical trials, the vaccine was found to be safe and effective in preventing typhoid fever with a single dose effectiveness of over 85% that lasted for at least 3 years. It can offer protection to children from age 6 months up to adults.

The oral vaccine is easy to administer without need of trained healthcare staff. It does not need cold chain transportation or storage like the injectable vaccines which require refrigeration. This makes the vaccine cost effective and suitable for mass immunization programs in low resource settings. The vaccine is stable at temperatures up to 40°C for four weeks and can withstand temperatures up to 100°C for short periods, facilitating use even in remote tropical areas.
Increases Access in Developing World

While injectable vaccines exist in the market, their use remains limited in developing nations due to cost and logistical challenges. The enteric fever vaccine can potentially increase vaccine access to at-risk populations in these countries. It has already been prequalified by WHO and piloted vaccination programs have shown promise. If introduced widely, it may help reduce the burden of typhoid in Asian and African regions where disease incidence is highest.

The vaccine manufacturer Bharat Biotech plans to make the oral typhoid vaccine available at an affordable price for public immunization programs. It aims to supply 25 million doses annually over the coming years. Several developing countries in Southeast Asia and Sub-Saharan Africa have expressed interest in introducing the oral vaccine in their routine immunization programs targeting school going children and young adults. Successful implementation could pave the way for controlling typhoid in these regions.

Increased Awareness and Demand

The WHO prequalification of the enteric fever vaccine is raising awareness about typhoid and the role of vaccination in prevention. It is increasing demand from disease endemic nations as well as international organizations funding immunization programs in low income settings. Global health experts project increased vaccine uptake once supply becomes widely available to fulfill the growing needs.

Meanwhile vaccination focus is shifting from travelers to at-risk local populations in endemic regions. Large effectiveness studies are ongoing in Asia and Africa to understand real world impact. Positive outcomes will provide evidence to guide vaccination policies. Data on vaccine impact, cost effectiveness and lessons from vaccination program delivery will help increase confidence in use of the oral typhoid vaccine approach over the coming years.

With focused efforts, the vaccine has potential to significantly reduce the health and economic burden of typhoid fever in developing nations. It may ultimately help eliminate the disease if used alongside other control strategies like water, sanitation and hygiene improvement programs. This simple oral vaccine could drive progress towards a typhoid-free world especially in resource constrained settings that are most impacted.

The new enteric fever vaccine delivers Immunization through a cost effective delivery mechanism suitable for both endemic areas and mass public health programs. It provides a safe alternative to existing injectable vaccines and increases opportunities to protect at risk populations from one of the leading infectious diseases affecting millions globally each year. Widespread introduction has potential for major health impact by controlling typhoid fever worldwide.