The World Health Organization (WHO) has prequalified the first conjugate vaccine for typhoid fever. The new typhoid fever vaccine, Typbar-TCV, is produced by Bharat Biotech International of Hyderabad, India. Prequalification means that the vaccine meets the WHO’s “acceptable standards of quality, safety and efficacy” and will now be available to be purchased by organizations promoting global vaccine programs such as UNICEF and Gavi (Global Alliance for Vaccines & Immunization), also known as The Vaccine Alliance.1
Typbar-TCV has been under development by Bharat Biotech since 2001 and, according to the company, “all aspects” of the new typhoid vaccine were “studied and evaluated in human clinical trials.”3
With 5 years of follow up data for seroconversion, Typbar TCV® at 25µg / dose has proven long term protection for children and adults alike, and can be administered to children from 6 months of age.3
In anticipation of Typbar-TCV’s eventual licensure for use in countries where typhoid is endemic, the Gavi’s board of directors, which includes representatives of UNICEF, WHO, the World Bank, the Bill & Melinda Gates Foundation, vaccine manufacturers and others, has already approved $85 million for procurement of Typbar-TCV starting in 2019.1 2 Kathleen Neuzil, MD, MPH, director of the Center for Vaccine Development at the University of Maryland School of Medicine, said “Typbar TCV® can be incorporated into routine vaccination schedules, giving us the best chance to reach children most at risk for this devastating disease.”3
The International Health Metrics and Evaluation (IHME) has estimated there were about 12 million cases of typhoid fever in the world in 2016, resulting in some 130,000 deaths.3
Typhoid fever is an acute infectious illness associated with poor hygiene and unsanitary living conditions. Typhoid is caused by Salmonellae Typhi bacteria and is most often contracted by ingesting contaminated food and water. Symptoms of the illness can include fever, fatigue, headache, abdominal pain, diarrhea, and constipation. A milder form of the illness can be caused by a related bacterium known as the Salmonella paratyphi.1 4
In the early 1900s, there were tens of thousands of cases of typhoid fever reported in the United States, but the disease is extremely rare (less than 400 cases annually) in the country due to improved sanitation.4 According to the Centers for Disease Control and Prevention (CDC), “Dramatic declines in incidence of and mortality from typhoid fever occurred in the United States after widespread implementation of municipal water and sewage treatment systems in the first half of the 20th century.”5
1 World Health Organization. WHO prequalifies breakthrough vaccine for typhoid. WHO.int (press release) Jan. 3, 2018.
2 Gavi, The Vaccine Alliance. Board composition. Gavi.org.
3 Bharat Biotech International. Typbar TCV® from Bharat Biotech, World’s First Typhoid Conjugate Vaccine Prequalified by WHO. Bharat Biotech International (press release) Jan. 3, 2018.
4 Typhoid Fever. WebMD
5 Centers for Disease Control and Prevention. Surveillance System Overview: National Typhoid and Paratyphoid Fever Surveillance (NTPFS). National Enteric Disease Surveillance: Typhoid and Paratyphoid Fever Surveillance Overview December 2011.