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

Kashmira Date Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia;

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Christopher LeBoa Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California;

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Seth A. Hoffman Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California;

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Pradeep Haldar Ministry of Health & Family Welfare, Government of India, New Delhi, India;

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Pauline Harvey World Health Organization-Country Office for India, National Public Health Surveillance Project, New Delhi, India;

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Qian An Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia;

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Chenhua Zhang Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia;

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Vijay N. Yewale Dr. Yewale Multispecialty Hospital for Children, Navi Mumbai, India;

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Savita Daruwalla Department of Pediatrics, NMMC General Hospital, Navi Mumbai, India;

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Dhanya Dharmapalan Dr. Yewale Multispecialty Hospital for Children, Navi Mumbai, India;

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Jeetendra Gavhane Department of Pediatrics, MGM New Bombay Hospital, MGM Medical College, Navi Mumbai, India;

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Shrikrishna Joshi Dr. Joshi’s Central Clinical Microbiology Laboratory, Navi Mumbai, India;

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Rajesh Rai Department of Pediatrics & Neonatology, Dr. D.Y. Patil Medical College and Hospital, Navi Mumbai, India;

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Varsha Rathod Rajmata Jijau Hospital, Airoli (NMMC), Navi Mumbai, India;

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Keertana Shetty Department of Microbiology, Dr. D.Y. Patil Medical College and Hospital, Navi Mumbai, India;

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Divyalatha S. Warrier Department of Pediatrics, Mathadi Trust Hospital, Navi Mumbai, India;

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Shalini Yadav Department of Microbiology, MGM New Bombay Hospital, Navi Mumbai, India;

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Rahul Shimpi World Health Organization-Country Office for India, National Public Health Surveillance Project, New Delhi, India;

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Niniya Jayaprasad World Health Organization-Country Office for India, National Public Health Surveillance Project, New Delhi, India;

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Lily Horng Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California;

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Kirsten Fagerli Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia;

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Priyanka Borhade World Health Organization-Country Office for India, National Public Health Surveillance Project, New Delhi, India;

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Debjit Chakraborty National Institute of Cholera and Enteric Diseases, Indian Council of Medical Research, Kolkata, India;

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Arun Katkar World Health Organization-Country Office for India, National Public Health Surveillance Project, New Delhi, India;

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Abhishek Kunwar World Health Organization-Country Office for India, National Public Health Surveillance Project, New Delhi, India;

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Jason R. Andrews Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California;

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Sunil Bahl World Health Organization South-East Asia Regional Office, New Delhi, India

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Pankaj Bhatnagar World Health Organization-Country Office for India, National Public Health Surveillance Project, New Delhi, India;

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Shanta Dutta National Institute of Cholera and Enteric Diseases, Indian Council of Medical Research, Kolkata, India;

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Stephen P. Luby Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California;

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DOI:
https://doi.org/10.4269/ajtmh.24-0181
Volume/Issue:
Ahead of Print
Open access
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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.

Author Notes

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.

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.

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.

Address correspondence to Seth A. Hoffman, Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, 300 Pasteur Dr., Lane Bldg. 134, Stanford, CA 94305. E-mail: shoff@stanford.edu
Copyright:
© The author(s) 2024
Received:
18 Mar 2024
|
Accepted:
12 May 2024
|
Published Online:
13 Aug 2024
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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