Advancing typhoid conjugate vaccine implementation in Asia: Regional policy priorities

Typhoid fever, a type of enteric fever transmitted through consumption of food or water contaminated with Salmonella enterica subspecies Typhi, continues to cause illness in Asia. Since the World Health Organization recommended use of typhoid conjugate vaccines in 2018, several countries have introduced or begun the decision-making process to use the vaccine in campaigns or by introduction into the routine immunization schedule. This paper describes the disease burden and vaccine implementation policy setting in the region, based on presentations and discussions at the second Asia Regional Meeting on Typhoid & TCV. Moving forward, typhoid control efforts must prioritize 1) working across health and finance ministries to finance vaccination programs, 2) strengthening surveillance to better understand disease burden, drug resistance trends, and vaccine impact, 3) developing improved diagnostic tests, 4) stewarding antimicrobial use to slow the spread of drug resistance, and 5) evaluating the durability of TCV protection.