TCV vaccines

WHO recommends the use of TCV for routine immunization programmes in typhoid-endemic countries. In settings with high or very-high incidence, a high CFR, or a high burden of antimicrobial-resistant S. Typhi, the first dose is recommended at 9–24 months of age. In medium-incidence settings, TCV introduction may be considered, particularly where disease is associated with a high CFR or a high burden of antimicrobial resistance; in such settings, the first dose may be administered at ≥2 years of age and may be delayed up to 5 years of age on the basis of local epidemiology and feasibility.^{Go to footnote 11}

WHO recommends catch-up vaccination with TCV at the time of vaccine introduction. The age range should be guided by local epidemiology and programmatic feasibility; children aged <15 years are often targeted.^{Go to footnote 11}

Countries with very-high typhoid incidence should consider a booster dose at around 5 years of age for children who received a primary TCV dose at 9–24 months of age. In high-incidence settings, a booster dose around 5 years of age may be considered if there is evidence of waning protection. In other settings where the primary dose was administered before 24 months of age, a booster may also be considered if waning protection is observed. National decisions should take into account typhoid incidence, CFR, antimicrobial resistance patterns, cost-effectiveness and programmatic feasibility. WHO recommends maintaining a minimum interval of one year between primary vaccination and the booster dose. In medium- or high-incidence settings, or where limited waning is observed, a booster may not be needed, particularly if the primary dose is administered at ≥2 years of age. If administering a booster dose is a significant barrier, this should not preclude the introduction and use of TCV without a booster.^{Go to footnote 11}