KATHMANDU: The government launched a new vaccine campaign introducing Typhoid Conjugate Vaccine (TCV) into the routine immunization program across the country on Thursday, with the support from Gavi, the Vaccine Alliance, World Health Organization (WHO), United Nations International Children’s Emergency Fund (UNICEF) and other partners.

Prime Minister Sher Bahadur Deuba inaugurated the campaign introducing TCV into the routine immunization program across country amidst a program, in Kathmandu, on Thursday.

The three-week campaign, which will run from April 8 to May 1, 2022, aims to reach all children aged between 15 months and 15 years to quickly achieve wider protection from typhoid, increase the impact of the vaccine introduction and combat the rise of antimicrobial resistance.

Over 50,000 vaccination sites have been established across rural and urban settings in the country, including schools. Immediately following the campaign, TCV will be introduced into the routine immunization schedule, and will be regularly administered to children at 15 months of age, stated a joint press release issued by partner organizations, Gavi, WHO and UNICEF.

The campaign aims to reach 95% coverage of nearly 7.5 million children with the typhoid conjugate vaccine (TCV) and simultaneously identify ‘zero-dose’ children and those that have missed other routine vaccines.

“Congratulations to the Government of Nepal on this milestone; the introduction of the TCV will ensure the lives of thousands of children are protected across the country for years to come, as well as helping to combat the rise of antimicrobial resistance. This is also a great opportunity to leverage this introduction to identify and reach those children being missed by other life-saving vaccines and essential health services,” said Anuradha Gupta, Deputy Chief Executive Officer of Gavi, the Vaccine Alliance.

Nepal is a typhoid-endemic country and is estimated to have one of the highest burdens of typhoid in the world. The nationwide introduction means children in the country under the age of 15 years will now be able to access the vaccine free of charge.

“Vaccines are among the best investments we can make to give every child a healthy start in life,” said Elke Wisch, UNICEF Representative to Nepal. “The introduction of the Typhoid-Conjugate Vaccine into Nepal’s national immunization program will save the lives of thousands of Nepali children and is critical to tackle the high burden of typhoid in children in the country. This expansion and further strengthening of routine vaccination services in Nepal is particularly timely in the wake of the COVID-19 pandemic, given the widespread impact it has had on regular health services.”

The TCV campaign will also strengthen and promote routine immunization in Nepal by identifying children aged 15 to 23 months that have missed other routine vaccines, and make sure they are able to access these vaccines and become fully immunized and protected, stated the release.

Based on lessons learned during the successful Measles Rubella Campaign in 2020, the TCV campaign will also be used to identify zero-dose children – children who haven’t received a single dose of the basic diphtheria, tetanus and pertussis-containing vaccines (DTP) vaccine. Zero-dose children face multiple deprivations and are markers of acute inequities, it added.

Children out of school will be identified through the Ministry of Education, Science and Technology and caregivers will be educated and informed about where to go for routine immunization through the support of local leadership and health workers. Good hygiene behavior will also be promoted throughout the campaign to help prevent the spread of the virus.

“The Typhoid Conjugate Vaccine is highly efficacious and its introduction in Nepal will significantly reduce the burden of typhoid disease among children in the country,“ said WHO Representative to Nepal, Dr Rajesh Sambhajirao Pandav. “Additionally, typhoid vaccination can slow the expansion of drug-resistant strains which is an emerging global health issue. Along with vaccination campaigns, Nepal must also strengthen surveillance for antimicrobial resistance, and work on improvement of sanitation and access to safe drinking water.”

Nepal is the fourth country supported by Gavi to introduce TCV into its routine immunization program. Pakistan, Liberia and Zimbabwe have all introduced the vaccine, with support from Gavi and partners including UNICEF.

In addition to typhoid vaccination programs, other efforts to control the disease, including health education, water, sanitation, and hygiene (WASH) improvements, and training of health professionals in diagnosis and treatment should be encouraged and implemented in countries.

The Global Burden of Disease study estimated that in 2019, there were at least 82,449 typhoid cases and 919 typhoid deaths in Nepal.