Pakistan was the first country to introduce TCV in its routine immunization schedule and is a global leader in protecting their children from typhoid. Starting from Sindh province in 2019, despite the Covid-19 pandemic emergency, the vaccine was introduced in Punjab and Islamabad in 2021.

“Pakistan has already vaccinated more than 30 million children with TCV in the past 3 years though the phased introduction. This final introduction campaign in urban areas of Khyber Pakhtunkhwa, Balochistan, Gilgit-Baltistan, and Azad Jammu and Kashmir provinces, will ensure another 5.5 million are vaccinated against TCV. With the current and the last phase, we fulfill Government of Pakistan’s commitment of TCV introduction country wide,” says Dr Muhammad Ahmed Kazi, Director General, Federal Directorate of Immunization.

The current floods in the country have disrupted access to health services, adding severe pressure on an already over-burdened health system. Millions of people are at higher risk for waterborne diseases, including diarrhea and typhoid.

Federal Directorate of Immunization, on request of Balochistan has managed to arrange additional 2,00,000 doses of TCV to reach population living in the flood affected districts.. “These are the children who have lost their homes. They need it the most and therefore we are managing the additional vaccine doses,”

The flooding has only exacerbated the risk of diseases as many WASH facilities have been compromised. The Minister of Health, Abdul Qadir Patel,has also directed the program to ensure that immunization—and protection against waterborne diseases —is an upmost priority in Pakistan.

“Our provincial EPI Managers are personally looking into it and the government of Pakistan with the support of partners, UNICEF, WHO, Gates Foundation is working to ensure it,” added Dr Kazi.

it is not just the vaccines that will help control or reduce the burden of typhoid; supplementary efforts for sanitation and hygiene have to complement such efforts. A dismal waste management system, poor access to potable water, and questionable hygiene practices and food preparation methods have left many people vulnerable to the infection which has a significant cost of treatment.

Once introduced in the EPI, the TCV will be the 12th antigen added to the list with support from Gavi, the Vaccine Alliance, like all other 11 vaccines, typhoid will also be available free of cost in routine immunisation programmes for the children of Balochistan

It is time we understood the importance of completing our children’s immunisation schedule and put in all efforts towards increasing vaccinations from its present rate of 49pc in the province, according to the Pakistan Demographic and Health Survey 2017-18

In the prevalent flood situation, when more than 33 million population has been affected by severe floods across the country.

However, as the world focuses on Covid-19 vaccines, we cannot afford to take our eyes off the ball when it comes to other deadly diseases, such as typhoid.

TCV is a one-dose vaccine, injected intramuscularly with high efficacy. It is the first typhoid vaccine that can be given to children as young as 6 months of age and confers longer term protection against typhoid.

The campaign will target 1.7 million children of 9 months to 15 years with objective of achieving at least 95% coverage. Target age Group: 9 months to 15 years urban population which is about 39% of total population

Despite the efforts put together by the Expanded Programme on Immunisation, the Polio Eradication Initiative, civil society organisations, UN partners, a massive campaign during the pandemic that is mandated to ensure coverage as high as 95 percent in target areas may face many challenges.

A large number of the target children are school going and teams have been vaccinating children in both public and private schools as well as madrassas.

However, the most vulnerable and difficult to trace is the group that includes children working as domestic help in homes, at auto workshops, vendors or are on the streets. These are the non-school going children aged between five years and above that may be the hardest to reach.

This third phase of the campaign, supported by Gavi, the Vaccine Alliance, the vaccine, like all other antigens, will be available free of cost to children under two years of age. Oral polio vaccine will also be offered to children under five years of age as part of this campaign—helping us to move even closer to eradicating this disease from the country.

The solution to the typhoid burden is an integrated one. Improvements in water, sanitation, and hygiene are imperative. So are improved diagnostics to ensure people are diagnosed promptly and treated appropriately. Avoiding injudicious or irrational use of antibiotics, combined with self-medication due to availability of antibiotics off the shelf without a doctor’s prescription are some reasons blamed for untreatable typhoid.

Typhoid is becoming a major public health due to increasing resistance to antibiotics leading to severe complications and deaths with consequent burden over health system. Purpose of a good quality TCV campaign is to improve the immunity against typhoid diseases and decrease the incidence of typhoid. TCV will be a part of EPI schedule all over the country after campaign ends.