A real-world perspective from Indian pediatricians on typhoid vaccination perceptions and preferences

S. P. Karamath; Sathish Pandya; Pavan Kumar; Manish Mahajan; Trayambak Dutta

doi:10.18203/2349-3291.ijcp20231760

Authors

S. P. Karamath Tan Man Child Care Clinic, Chennai, Tamil Nadu, India
Sathish Pandya Varun Complete Healthcare, Vadodara, Gujarat, India
Pavan Kumar Department of Pediatrics, MNR Medical College, Telangana, India
Manish Mahajan Zydus Life Sciences, Ahmedabad, Gujarat, India
Trayambak Dutta Zydus Life Sciences, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20231760

Keywords:

Typhoid, TCV, Paediatricians, Awareness, Dosage

Abstract

Background: Typhoid vaccines are not a part of national immunization schedule in India, current survey aimed to evaluate pediatricians’ perception, recommendation patterns, and preference regarding typhoid conjugate vaccine (TCV) in children and adults.

Methods: This was an observational, cross-sectional survey amongst 500 pediatricians practicing at various healthcare setups/clinics/hospitals located across India. The perception, recommendation patterns, and preference of pediatricians regarding TCV were assessed using a pre-defined, structured, and self-administered questionnaire which consisted of 25 open- and close-ended questions.

Results: TCV was highly recommended in children aged 9-24 months (61%), with only 57% of the recommended age group being vaccinated. The lowest TCV recommendations were observed in the age groups 5-12 years (35%) and 12-18 years (25%). The predominant barriers for parents who are not getting their >12 years old children vaccinated include lack of parent’s awareness that TCV can be given to adolescents (61%) and wrong assumption of parents that their child was vaccinated when young (56%). The top key factors influencing parents in getting their children vaccinated included advice of doctors, mention in the vaccination card, previous vaccination of elder sibling, and children suffering from typhoid.

Conclusions: Overall pediatrician recommendations and parent acceptance rates of TCV for their children is low. Pediatricians included in the study believe that 2 doses of TCV are necessary for paediatric age group. Advice of the doctor, mention of TCV in vaccination card and awareness activities by pharmaceutical companies play a crucial role in improving the typhoid immunization rates with TCV.

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References

Crump JA. Progress in Typhoid Fever Epidemiology. Clin Infect Dis. 2019;68(1):S4-s9.

The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Infect Dis. 2019;19(4):369-81.

John J, Van Aart CJ, Grassly NC. The Burden of Typhoid and Paratyphoid in India: Systematic Review and Meta-analysis. PLoS Negl Trop Dis. 2016;10(4):e0004616.

Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1151-210.

Cao Y, Karthikeyan AS, Ramanujam K, Raju R, Krishna S, Kumar D et al. Geographic Pattern of Typhoid Fever in India: A Model-Based Estimate of Cohort and Surveillance Data. J Infect Dis. 2021;224(224-5):S475-83.

Parry CM, Ribeiro I, Walia K, Rupali P, Baker S, Basnyat B. Multidrug resistant enteric fever in South Asia: unmet medical needs and opportunities. BMJ. 2019;364:k5322.

Strategic Advisory Group of Experts on Immunization (SAGE) Geneva: World Health Organization. 2017. Available at: https://www.who.int/groups/strategic-advisory-group-of-experts-on-immunization. Accessed on 25 march 2023.

Mohan VK, Varanasi V, Singh A, Pasetti MF, Levine MM, Venkatesan R et al. Safety and immunogenicity of a Vi polysaccharide-tetanus toxoid conjugate vaccine (Typbar-TCV) in healthy infants, children, and adults in typhoid endemic areas: a multicenter, 2-cohort, open-label, double-blind, randomized controlled phase 3 study. Clin Infect Dis. 2015;61(3):393-402.

Dash N, Rose W. Typhoid Conjugate Vaccine: Is It Time for It To Be in the National Immunization Schedule? Indian Pediatr. 2020;57(7):609-10.

Vashishtha VM, Kalra A. The need and the issues related to new-generation typhoid conjugate vaccines in India. Indian J Med Res. 2020;151(1):22-34.

Kasi SG, Shivananda S, Marathe S, Chatterjee K, Agarwalla S, Dhir SK et al. Indian Academy of Pediatrics (IAP) Advisory Committee on Vaccines and Immunization Practices (ACVIP): Recommended Immunization Schedule (2020-21) and Update on Immunization for Children Aged 0 Through 18 Years. Indian Pediatr. 2021;58(1):44-53.

Sharma R, Bhasin SK. Routine immunization-do people know about it? A study among caretakers of children attending pulse polio immunization in East delhi. Indian J Community Med. 2008;33(1):31-4.

Chauhan AS, Kapoor I, Rana SK, Kumar D, Gupta M, John J et al. Cost effectiveness of typhoid vaccination in India. Vaccine. 2021;39(30):4089-98.

Ryckman T, Karthikeyan AS, Kumar D, Cao Y, Kang G, Goldhaber-Fiebert JD et al. Comparison of Strategies for Typhoid Conjugate Vaccine Introduction in India: A Cost-Effectiveness Modeling Study. J Infect Dis. 2021;224(5):S612-24.

Sunny A RS, Shankar BK. A Study to Assess and Correlate the Knowledge, Attitude and Practices of Vaccination among Mothers with Educational Status in a Teaching Hospital in South India. Prim Health Care: 2018;8(1):1-6.

DAS S. Knowledge Regarding Typhoid Fever among Mothers of Under 5 Children in Selected Community of Bhaktapur, 2019. Int J Innovative Sci Res Technol. 2019;5(10).