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MUMBAI: Mumbai has been chosen as one of the sites for a typhoid surveillance study to evaluate the need for including the Typhoid Conjugate Vaccine (TCV) in India’s national immunisation schedule for children up to the age of 14. This is the second round of surveillance, despite the previous research providing sufficient data to support the vaccine’s inclusion in the immunisation programme.
A training workshop for BMC officials was held by the Union ministry of health and family welfare at the end of Nov. As of now, about nine public and private health facilities in the city have been selected for typhoid surveillance. Samples from paediatric patients will be collected from these health centres and sent to the molecular lab at Kasturba Hospital, which will further relay them to the health ministry’s vaccine study units.
“The surveillance has not yet started; we are in the preparation stage,” said Dr Daksha Shah, BMC’s executive health officer. Apart from Mumbai, some of the other typhoid surveillance sites include cities in Bihar, Uttar Pradesh, and Gujarat.
The initiative is supported by the World Health Organization and Global Alliance for Vaccines and Immunization (GAVI). “The previous study was reasonably comprehensive to move ahead with the vaccine rollout. Another study is a way of buying more time to formulate a policy,” said a senior doctor previously associated with the National Technical Advisory Group on Immunisation (NTAGI). The group consists of top medical professionals from across the country who advise govt on vaccination.
In 2016, NTAGI recommended the formation of the Surveillance for Enteric Fever in India to understand the burden of typhoid and the need for a vaccine. Subsequently, studies were conducted at 18 rural and urban sites between 2017 and 2020. The data, which suggested a higher burden of typhoid fever in urban centres than in rural areas – 1,622 cases per one lakh children in some locations – was enough for NTAGI to tell the health ministry in 2023 that “it is worthwhile to introduce the Typhoid Conjugate Vaccine in the Universal Immunization Programme”.
The push for the typhoid vaccine is due to the increasing drug resistance observed over time. A report published earlier this year by the Indian Council of Medical Research highlighted that typhoid is one of the diseases where commonly used antibiotics have become less effective.
The former NTAGI doctor said, “More data also means inclusion of areas that were not represented in the earlier studies, which could also be why there is another set of study. There will be an impact assessment after this, which is the introduction of the vaccine to a certain scale to understand if it makes a difference to those who received it and the larger public health.”
Conjugate vaccines are a type of subunit vaccine that use part of a germ and sugar molecules from its surface to help the body recognise and fight the germ better.
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