Bangladesh faces a significant burden of typhoid fever, with over 300 cases per 100,000 people each year. Children, particularly those under the age of 15, account for nearly 60% of these cases. To address this challenge, the government has made a strategic decision to introduce typhoid conjugate vaccines (TCV) into the routine immunisation program, aiming to protect the most vulnerable. This introduction is seen as a key step in strengthening the country’s child immunization efforts, especially as cases of drug-resistant typhoid are on the rise. 

A recent cost-effectiveness modelling study offers a clear picture of why this move is both essential and timely. According to the study, if no action is taken, Bangladesh could face over 4.7 million typhoid cases in the next decade. This would result in more than 14,000 deaths and lead to a societal loss exceeding US$500 million, largely due to the wages caregivers lose while tending to sick children. These numbers highlight the high cost of inaction.

The study evaluated several TCV introduction strategies over the next 10 years, and all were found to be cost-effective. These strategies included vaccinating children between 9 and 12 months of age nationwide, along with a catch-up campaign for children aged 1 to 15 years. Another option was a school-based catch-up campaign for children aged 5 to 15, which would include vaccination at school entry for those who had not yet been immunised.

Among the options considered, the most cost-effective was the combination of routine vaccination for children aged 9 to 12 months and a community-based catch-up campaign for children aged 1 to 15. This approach is projected to prevent nearly 4 million typhoid cases and over 11,000 deaths in the next decade, saving the country more than US$172 million. Importantly, the study also showed that a community-based campaign is more efficient than a school-based one, as it has the potential to reach more children at a lower operational cost.

Beyond the economic benefits, TCV introduction is expected to significantly reduce the health burden on families. Typhoid diagnosis and treatment are often costly, with a previous study showing that medical expenses, including registration fees, hospital stays, medications, and transport, can account for 3% of an individual’s annual income. For those needing inpatient care, this figure rises to 14%. By preventing illness through vaccination, families can avoid these costs, reducing financial strain and ensuring children stay healthy.

The government’s decision to introduce TCV comes at a crucial time, as climate change and rising drug resistance heighten the risks associated with typhoid. With the introduction of this vaccine, Bangladesh is taking a proactive approach to protect its children from a preventable disease, saving both lives and money.

This initiative aligns with the country’s broader public health goals and strengthens its commitment to safeguarding the health of its youngest citizens. By investing in vaccination, Bangladesh is not only addressing a pressing health challenge but also creating a healthier, more prosperous future for the next generation.

Reference 

Weyant C, Hooda Y, Munira SJ, Lo NC, Ryckman T, Tanmoy AM, et al. Cost-effectiveness and public health impact of typhoid conjugate vaccine introduction strategies in Bangladesh. Vaccine [Internet]. 2024;42(11):2867–76. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0264410X24003220