Field Effectiveness of a Typhoid Conjugate Vaccine: The 2018 Navi Mumbai Pediatric TCV Campaign

Typbar-TCV®, a typhoid conjugate vaccine (TCV), was prequalified by the World Health Organization in 2017. We evaluated its effectiveness in a mass vaccination program targeting children 9 months to 14 years in Navi Mumbai, India, from September 2018 to July 2020. We compared laboratory-confirmed ty...

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Published inThe American journal of tropical medicine and hygiene Vol. 111; no. 4; pp. 848 - 852
Main Authors Date, Kashmira, LeBoa, Christopher, Hoffman, Seth A, Haldar, Pradeep, Harvey, Pauline, An, Qian, Zhang, Chenhua, Yewale, Vijay N, Daruwalla, Savita, Dharmapalan, Dhanya, Gavhane, Jeetendra, Joshi, Shrikrishna, Rai, Rajesh, Rathod, Varsha, Shetty, Keertana, Warrier, Divyalatha S, Yadav, Shalini, Shimpi, Rahul, Jayaprasad, Niniya, Horng, Lily, Fagerli, Kirsten, Borhade, Priyanka, Chakraborty, Debjit, Katkar, Arun, Kunwar, Abhishek, Andrews, Jason R, Bahl, Sunil, Bhatnagar, Pankaj, Dutta, Shanta, Luby, Stephen P
Format Journal Article
LanguageEnglish
Published United States Institute of Tropical Medicine 02.10.2024
The American Society of Tropical Medicine and Hygiene
Subjects
Adolescent
Child
Child, Preschool
Female
Humans
India - epidemiology
Infant
Male
Mass Vaccination
Salmonella typhi - immunology
Short Report
Typhoid Fever - epidemiology
Typhoid Fever - prevention & control
Typhoid-Paratyphoid Vaccines - administration & dosage
Typhoid-Paratyphoid Vaccines - immunology
Vaccine Efficacy
Vaccines, Conjugate - immunology
India
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Summary:Typbar-TCV®, a typhoid conjugate vaccine (TCV), was prequalified by the World Health Organization in 2017. We evaluated its effectiveness in a mass vaccination program targeting children 9 months to 14 years in Navi Mumbai, India, from September 2018 to July 2020. We compared laboratory-confirmed typhoid cases from six clinical sites with age-matched community controls. Of 38 cases, three (8.6%) received TCV through the campaign, compared with 53 (37%) of 140 controls. The adjusted odds ratio of typhoid fever among vaccinated children was 0.16 (95% CI: 0.05-0.55), equivalent to a vaccine effectiveness of 83.7% (95% CI: 45.0-95.3). Vaccine effectiveness of Typbar-TCV in this large public sector vaccine introduction was similar to prior randomized controlled trials, providing reassurance to policymakers that TCV effectiveness is robust in a large-scale implementation.
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Disclosure: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position, policies, or views of the U.S. Centers for Disease Control and Prevention or the World Health Organization.
Financial support: This work was supported by Bill & Melinda Gates Foundation grant OPP1169264 (principal investigator S. P. Luby). C. LeBoa is funded by the Global Health Equity Scholars Program NIH FIC (Award no. D43TW010540). S. A. Hoffman is supported in part by the NIH under the National Institute of Allergy and Infectious Diseases grant T32AI007502, as well as by the Stanford Maternal and Child Health Research Institute. K. Date reports CDC employee—salary through employer.
Current contact information: Kashmira Date, Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, and Johnson & Johnson Global Public Health, New Brunswick, NJ, E-mail: kashmira.date@gmail.com. Christopher LeBoa, National Public Health Surveillance Project, Country Office for India, World Health Organization, New Delhi, India, and Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, E-mail: cleboa@berkeley.edu. Seth A. Hoffman, Jason R. Andrews, Stephen P. Luby, Lily Horng and Kirsten Fagerli, Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, E-mails: sethhoffman@stanford.edu. jandr@stanford.edu, sluby@stanford.edu, lily.horng@gmail.com, and kirsten.fagerli@mcri.edu.au. Pradeep Haldar, Ministry of Health & Family Welfare, Government of India, New Delhi, India, E-mail: pradeephaldar@yahoo.co.in. Pauline Harvey, U.S. Centers for Disease Control and Prevention, Atlanta, GA, E-mail: pdh7@cdc.gov. Qian An, Chenhua Zhang, Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: fei8@cdc.gov and noi7@cdc.gov. Vijay Yewale and Dhanya Dharmapalan, Dr. Yewale Multispecialty Hospital for Children, Navi Mumbai, India, E-mails: vnyewale@gmail.com and drdhanyaroshan@gmail.com. Savita Daruwalla and Rajesh Rai, Department of Pediatrics, NMMC General Hospital, Navi Mumbai, India, E-mails: childoc62@gmail.com and drrajeshrai@yahoo.com. Jeetendra Gavhane, Department of Pediatrics, MGM New Bombay Hospital, MGM Medical College, Navi Mumbai, India, E-mail: drjeetendra@gmail.com. Shrikrishna Joshi, Dr. Joshi’s Central Clinical Microbiology Laboratory, Navi Mumbai, India, E-mail: skajoshi@yahoo.co.in. Varsha Rathod, Rajmata Jijau Hospital, Airoli (NMMC), Navi Mumbai, India, E-mail: vrmsrjhairoli@gmail.com. Keertana Shetty, Department of Microbiology, Dr. D.Y. Patil Medical College and Hospital, Navi Mumbai, India, E-mail: keertana.shetty@gmail.com. Divyalatha S. Warrier, Department of Pediatrics, Mathadi Trust Hospital, Navi Mumbai, India, E-mail: divyawarrier60@gmail.com. Shalini Yadav, Department of Microbiology, MGM New Bombay Hospital, Navi Mumbai, India, E-mail: doc_shalini@rediffmail.com. Niniya Jayaprasad, India Hypertension Control Initiative, World Health Organization, New Delhi, India, E-mail: niniya.jayaprasad@yahoo.com. Priyanka Borhade, Rahul Shimpi, Arun Katkar, Abhishek Kunwar, Pankaj Bhatnagar, National Public Health Surveillance Project, Country Office for India, World Health Organization, New Delhi, India, E-mails: dm.tcvwho@gmail.com, shimpir@who.int, katkara@who.int, abhishekk@who.int, and bhatnagarp@who.int. Debjit Chakraborty, National Institute of Cholera and Enteric Diseases, Indian Council of Medical Research, Kolkata, India, E-mail: drdebjitepi@gmail.com. Sunil Bahl, South-East Asia Regional Office, World Health Organization, New Delhi, India, E-mail: bahls@who.int. Shanta Dutta, National Institute of Cholera and Enteric Diseases, Indian Council of Medical Research, Kolkata, India, E-mail: drshantadutta@gmail.com.
ISSN:0002-9637
1476-1645
1476-1645
DOI:10.4269/ajtmh.24-0181