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Typhoid fever vaccination strategies
Kashmira A Date1, Adwoa Bentsi-Enchill2, Florian Marks3
1Global Immunization Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329-4027, USA.
Typhoid vaccination strategies using available vaccines are effective and feasible for disease control. Despite successes, typhoid vaccines remain underused, highlighting the need for optimized strategies, especially with new typhoid conjugate vaccines (TCVs).
Area of Science:
- Public Health
- Vaccinology
- Infectious Disease Epidemiology
Background:
- Typhoid fever prevention relies on vaccination, recommended for endemic and outbreak settings.
- Current strategies utilize Vi polysaccharide vaccine (ViPS) and oral Ty21a, with limited experience in disaster/outbreak scenarios.
Purpose of the Study:
- To review and assess experiences with existing typhoid vaccination strategies.
- To inform future typhoid vaccination strategies, particularly with the advent of typhoid conjugate vaccines (TCVs).
Main Methods:
- Systematic review of vaccination strategies categorized by disease control (preemptive/reactive) and delivery (routine/campaign/school-based).
- Evaluation of rationale, acceptability, effectiveness, impact, and implementation lessons.
Main Results:
- ViPS and Ty21a vaccines demonstrated acceptability, feasibility, and effectiveness across various settings.
- Impact evidence was strongest in endemic areas; cost-effectiveness was observed in high-incidence settings.
- Limited program experience exists for newer TCVs, though they offer potential advantages like infant use and longer protection.
Conclusions:
- Existing typhoid vaccination strategies are successful but underutilized.
- Implementation lessons should guide the optimal use of TCVs for enhanced typhoid prevention and control.
- TCVs present significant advantages over older vaccines for future public health programs.
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