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New generation of typhoid vaccines rolled out across Malawi

Dorica Kamphikire from Kaombe Village, in Mchinji shows her vaccination card

Image credit: TyVac/Madalitso Mvula

A nationwide rollout of the latest typhoid vaccine for all children under 15 has begun in Malawi.

Following successful vaccine trials in Malawi, more than 7 million children in the country have received Typhoid Conjugate Vaccine (TCV), in one of the largest immunisation campaigns ever conducted in the country. The vaccine is now being included as routine for all children going forward.

The first major advance in typhoid vaccines in a generation, TCV can improve immunological responses and memory, and the trials have now proved that they offer increased efficacy over older vaccines, from around 55% to over 80%.

The clinical trials of TCV, led by the Malawi-Liverpool-Wellcome Programme (MLW), were the first in Africa and showed that the vaccine was 84% effective to prevent episodes of typhoid, and also showed excellent safety and cost-effectiveness. More than 28,000 children living in Malawi participated in the trial, which paved the way for national roll-outs in Malawi and other African countries.

MLW is a partnership between the Kamuzu University of Health Sciences, the University of Liverpool and the Liverpool School of Tropical Medicine, with funding from the Wellcome Trust.

The trial followed 10 years of work establishing the pattern and burden of rapidly-spreading Typhoid in Malawi. The need for the vaccine is particularly urgent because of recent increases in multi-drug antibiotic resistance across the continents of Africa and Asia.

The University of Liverpool’s Professor Melita Gordon, head of the Salmonella research group at MLW and a UK NIHR Research Professor said: “I am immensely proud of what has been achieved with our local participants, our teams of health workers, our local scientists, and our longstanding partners in the Malawi Ministry of Health and Kamuzu University of Health Sciences. Our typhoid research over more than a decade is now making a real impact on Malawi’s population health, preventing many illnesses, improving the lives of families, and saving lives. We hope to soon see more countries introduce TCV and help save more lives.”

You can read more about the TCV programme in a blog from Dr Mike Chisema, an Expanded Program on Immunisation manager based in Malawi: https://www.coalitionagainsttyphoid.org/amidst-challenges-malawi-delivers-for-the-children/

The clinical trial of TCV was funded by the Bill and Melinda Gates Foundation, and conducted in partnership with the Center for Vaccine Development and Global Health (CVD) at the University of Maryland School of Medicine. Financial support for the national roll-out in Malawi was made available through GAVI, the Vaccine Alliance for vaccines in low and middle-income countries.

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