Beat typhoid in Pakistan: Why vaccines are your secret weapon!

Imagine a world without typhoid fever – a disease that strikes millions in Pakistan every year. Typhoid spreads through contaminated food or water, often linked to poor sanitation and hygiene. Children are especially vulnerable, with high rates in the 2-15-year age group. A major concern is the ongoing outbreak of extensively drug-resistant (XDR) typhoid since 2016. Early diagnosis and access to appropriate antibiotics are essential for treatment, though XDR strains pose a challenge due to limited effective antimicrobial options

Why is typhoid a serious public health challenge?

Water supply contaminated with human waste remains the major cause of typhoid’s persistence in low socioeconomic areas. Safe drinking water and proper sanitation are crucial for controlling the spread, but millions of people in Pakistan lack proper sanitation facilities. This is particularly true in rural areas, but even in developed areas, rapid urbanization and overpopulation with inadequate infrastructure put a strain on existing sanitation systems and ultimately contamination of water sources. Illiteracy and self-medication with antibiotics is another challenge contributing to rising antimicrobial resistance and with the COVID-19 pandemic, treatment of typhoid became a challenge as focus was driven towards limiting the COVID-19 spread, and use of azithromycin as an experimental treatment for SARS-CoV-2 led to further development of resistance and hence limiting treatment options for management of XDR typhoid

Enter the TCV: Your hero in a shot!

Here’s the good news: we have a powerful weapon – the Typhoid Conjugate Vaccine (TCV)! Vaccines prevent 4–5 million people from dying from fatal diseases each year, and vaccination remains the simplest, safest, and effective way of prevention from serious illness and complications of vaccine-preventable diseases. Typhoid vaccination has been proven effective for the prevention and control of typhoid. Pakistan is the first country to introduce the typhoid conjugate vaccine (TCV) in the extended program on immunization (EPI) and has vaccinated over 30 million children in the country with an effectiveness of 95% against protection from typhoid. The first single dose of TCV provides prolonged immunity and is effective and safe for children between 6 months and 2 years of age

However, a challenge exists!

Vaccine hesitancy is a concern in Pakistan, particularly regarding typhoid. The World Health Organization (WHO) identified vaccine reluctance as a threat to global health; it can predispose to infections not only with Salmonella typhi but various other foodborne pathogens, regardless of proper antibiotic treatment in appropriate dosage and duration. Perceived lack of need, safety concerns, misinformation and mistrust in healthcare systems, false religious beliefs, and philosophical convictions like a healthy lifestyle will prevent sickness or that active immunity obtained after natural infection is superior to that acquired by vaccination are factors contributing to vaccination refusal.

Together, we can win!

Overcoming hesitancy is crucial for achieving high vaccination rates. Public health campaigns targeted at specific concerns and demographics are required to overcome all kinds of myths associated with vaccination through mass education programs to build trust in vaccines. Social media campaigns have been carried out to increase understanding and knowledge regarding the significance of vaccination against Salmonella typhi and to provide clear, science-based information through trusted sources.

The government is working hard to make TCV accessible to everyone and has launched multiple immunization campaigns periodically throughout the provincial and territorial urban areas of Pakistan. Despite all these efforts, the vaccine coverage gap does, however, exist and extreme measures are required to implement vaccination at all levels and to improve vaccine availability through home visits, mobile clinics, especially in rural areas.

By addressing these challenges, Pakistan can increase vaccine confidence and protect its population.

What can YOU do?

• Talk to your doctor about TCV for your children.
• Advocate for the provision of clean water, raise awareness regarding the intake of boiled water and hygienic food
• Share reliable information about vaccines with friends and family.
• Support efforts to increase access to vaccines in your community.

By working together, we can overcome vaccine hesitancy and protect all Pakistanis from the misery of typhoid. Let’s make Pakistan a typhoid-free zone!