This week, Malawi is embarking on a national vaccination campaign to reach more than 9 million children. The integrated campaign will launch typhoid conjugate vaccines (TCVs) into the routine immunization system and will also provide polio and measles-rubella vaccines and vitamin A supplementation.
Typhoid conjugate vaccines reach Malawi
Malawi has a staggering typhoid burden, with surveillance data showing 444 cases per 100,000 people per year. Most of these cases occur in children younger than 15 years old. Rising drug resistance trends and impacts from climate change both raise the risks of increased typhoid transmission and the urgency for preventative measures.
“We’re already seeing the impact of climate change in Malawi,” said Emmanuel Mugisha, PATH’s Typhoid Vaccine Acceleration Consortium Project Director. “Cyclone Freddy was one of the worst storms to hit Malawi, and its aftermath has increased the risks of waterborne diseases, including typhoid.”
“We’re already seeing the impact of climate change in Malawi. Cyclone Freddy was one of the worst storms to hit Malawi, and its aftermath has increased the risk of waterborne diseases, including typhoid.”— Emmanuel Mugisha, PATH
The Malawian government has prioritized child health by providing one of the most effective tools we have in typhoid prevention—vaccines. In a recent study, TCVs showed 84 percent efficacy in Malawian children. The introduction of this vaccine has the potential to protect millions from typhoid.
This week, vaccinators across the country will aim to immunize more than 9 million children from 9 months old to under 15 years old with TCVs. Vaccines will be available at mobile and non-mobile sites, including clinics, via mobile outreach teams, and schools. After this campaign, Malawi will transition to routine immunization, where TCVs will be available at 9 months of age.
Strengthening routine immunization
The COVID-19 pandemic disrupted routine immunization services throughout the world, and an estimated 25 million children missed routine vaccinations in 2021. Measles cases have increased globally, and in 2022 Malawi experienced its first polio case in 30 years.
New vaccine introductions offer an opportunity to strengthen routine immunization services. The mass mobilization of resources required to reach millions of children quickly throughout the country is an ideal time to reach hard-to-reach populations or identify children who may have missed other routine vaccinations. Malawi is taking advantage of this TCV campaign to also provide polio vaccines, measles-rubella vaccines, and vitamin A supplementation to age-eligible children.
The key to success? Planning
Large-scale immunization campaigns require a herculean effort, especially when they are as complex as this one, with multiple disease targets, interventions, and ages served. You need to know where the eligible children live; inform and train doctors, nurses, and thousands of vaccinators; plan supply logistics so that the correct amount of vaccines are available in each area and properly stored; and mobilize parents and caregivers countrywide to bring their children to vaccination sites during the campaign.
All of this requires significant, granular planning. Microplans detail all aspects of vaccine delivery. Malawi’s Expanded Programme on Immunization works with partners on a communication strategy and also develops and tests messages and materials to ensure they are clear, understandable, and culturally appropriate. The government also trains the health workforce on the new vaccines and the diseases they address.
PATH, as part of the Typhoid Vaccine Acceleration Consortium, was a key partner to Malawi’s Ministry of Health and Expanded Programme on Immunization to support these critical activities. Through our office in Malawi, PATH provided local support to plan and prepare, which was particularly useful as new challenges arose, including Cyclone Freddy.
Health surveillance assistants from Nsalu Health Centre walk to Phanga Village carrying vaccines and supplies for a mobile vaccination site during Malawi’s typhoid conjugate vaccine campaign. Photo: PATH/Madalitso Mvula.
We are proud of the work we have done to support Malawi with this monumental vaccination campaign. The road to get here has been full of recent challenges, but we are focused and dedicated to getting this typhoid vaccine to children. Protecting children against vaccine-preventable infectious diseases is an investment in our children’s futures, allowing them to grow up happy, strong, and to reach their full potential.
Learn more by visiting the Take on Typhoid website.
