MALAWI has launched a nationwide integrated vaccine campaign with the support of Gavi, (the Vaccine Alliance), WHO, UNICEF, TyVAC, and other partners. The campaign aims to deliver measles-rubella (MR) vaccines, typhoid conjugate vaccine (TCV), and a vitamin A supplement to more than 9 million children up to 15 years old in the country.
The initiative will also introduce TCV into the national routine immunisation programme, with the vaccine available at health facilities and mobile outreach teams throughout the country. This campaign will target hard-to-reach populations and ensure equitable access to the vaccine, which is highly effective at preventing typhoid fever.
Following the campaign, the typhoid vaccine will be available through routine vaccination at health centres across all districts and will be given to 9-month-old children alongside the first dose of a measles-containing vaccine. The push, which has been planned for multiple years, comes at a critical time for Malawi, as it grapples with the impact of Cyclone Freddy and outbreaks of polio and cholera.
Dr Mike Chisema, Expanded Programme on Immunisation (EPI) Manager, Ministry of Health Malawi, stated, ‘With the support of partners, we are proud to launch this integrated campaign, and introduce the TCV vaccine thereafter, that will help give our children the opportunity for a better future. With outbreaks of typhoid and the rise of anti-microbial resistant strains, primary prevention through vaccination is a game-changer.’
Typhoid fever is life-threatening, and the typhoid conjugate vaccine, approved by WHO in 2018, is highly effective at preventing typhoid fever, making national introduction of TCV a high priority. Malawi has endemic typhoid transmission, and the country has experienced typhoid outbreaks throughout the country. Recent studies in Malawi have shown that TCV is highly effective for the country context, and there is a high prevalence of multidrug-resistant typhoid fever.
Malawi has faced multiple health challenges due to climate change, natural disasters, and displacement, which increase the risk of typhoid outbreaks. Despite traditionally high basic vaccine coverage, the country saw a drop in routine immunisation coverage rates due to the pandemic, from 95 percent to 93 percent (3rd dose pentavalent vaccine coverage), and is overdue for a measles vaccine campaign to catch missed children and reduce the risk of outbreaks.
To ensure the best health outcomes and protection against multiple diseases, the polio vaccine is included in this national campaign, targeting children under five. Since 2022, Malawi has also conducted multiple cholera outbreak response campaigns, including the launch of the ‘Tithetse kolera (End Cholera)’ campaign in 2023 to control the current outbreak. The government, with support from partners, also conducts regular campaigns to deliver vitamin A supplements to improve immunity and health outcomes.
The integrated approach used in this national campaign makes the best use of available resources to deliver lifesaving impact – recognising the limited capacity of healthcare workers who have been stretched to the maximum to address multiple health challenges individually. Countries often conduct regular ‘catch-up’ campaigns to improve vaccine coverage and reach those who may have missed out, and this is particularly important following emergencies. Malawi’s campaign targets hard-to-reach populations, including those impacted by the recent Cyclone Freddy, to ensure equitable access to vaccines.
Gavi is continuing to support high-burden countries to introduce TCV – including by helping to strengthen disease diagnostic testing and surveillance, in order to assess disease burden and guide decision-making for impactful vaccine use. Malawi is the sixth country in the world, and third African country, to introduce TCV into its routine immunisation programme. , after Pakistan, Liberia and Zimbabwe.