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Nepal introduces TCV
Nepal introduced typhoid conjugate vaccine (TCV) in April, beginning with a 3-week campaign to reach 7 million children aged 15 months to 15 years old at 50,000 vaccination sites across the country. Nepal has one of the highest typhoid burdens in the world, with increasing rates of drug-resistant typhoid. The introduction of this vaccine is a key step in reducing Nepal’s typhoid burden and a major milestone toward protecting children from this disease. Following the campaign, Nepal is transitioning to routine immunization where TCV will be given to all children at 15 months of age.
PATH, as part of the Typhoid Vaccine Acceleration Consortium, supported Nepal throughout the decision-making and introduction process. We worked closely with government partners and international organizations to support Nepal in preparing its application to Gavi, the Vaccine Alliance and activities for vaccine introduction, community outreach, and social mobilization.
Framework for the allocation of limited malaria vaccine supply
The World Health Organization (WHO)-coordinated framework for the allocation of limited malaria vaccine supply has been prepared to guide the global allocation of the first malaria vaccine, RTS,S/AS01, and other malaria vaccines as they become available. RTS,S is the first and currently the only malaria vaccine recommended by WHO. It is projected that—at scale—it could save the lives of tens of thousands of children each year as part of integrated malaria control programs in moderate to high transmission areas. However, currently available supply is expected to fall short of demand for the first several years of wider implementation. This framework is meant to help inform national decisions about how to prioritize vaccines for routine introduction until current supply constraints can be resolved. PATH supports the framework to ensure equitable access to the vaccine while supply is constrained, and to assist decision-makers as they prioritize vaccine introductions in the near future. 
Switching rotavirus vaccines can save countries money, Ghana study confirms
In 2020, Ghana switched from using ROTARIX® to ROTAVAC® in its national immunization program. This switch was motivated by ROTAVAC’s lower cost and cold chain requirements. In the year after the switch, PATH worked with the Ghana Health Service and the University of Ghana to analyze the economic implications, including cost of delivery, overall cost-effectiveness, and cold chain impacts. Overall, the study validated Ghana’s decision, finding that the switch was both cost-saving and freed up cold chain space for other vaccines. PATH recently published a case study exploring the key results.
This study comes at a time when many countries may consider switching rotavirus vaccines. The availability of several new, more affordable rotavirus vaccine products and presentations has encouraged countries to weigh all available options. The Ghana study provides reassurance that switching to newer options such as ROTAVAC can be a cost-effective or cost-saving alternative. An earlier analysis of a similar switch in Palestine from 2018 also confirmed that switching to ROTAVAC was cost-saving and maintained similar levels of protection from rotavirus diarrhea. These data are particularly important as countries graduate from Gavi support and consider costs and sustainability moving forward.
Malawi’s village volunteers go door-to-door with vaccine messages
From updating communities with information on the lifesaving benefits of vaccines to addressing myths and misinformation, village volunteers across Malawi provide essential support for childhood immunization services. In many instances, these volunteers go house-to-house in villages served by their health facilities. These volunteers have played an essential role, for example, in helping ensure the RTS,S/AS01 malaria vaccine reaches as many Malawian children as possible. Since 2019, Malawi has been one of three African countries (in addition to Ghana and Kenya) that has provided RTS,S to children living in areas with moderate to high malaria transmission.
To support health facilities, volunteers have been encouraging parents to bring children in for vaccination even if they are late for their doses. Volunteers also emphasize components of a larger health package. For example, since RTS,S is one part of malaria prevention, vaccinated children should continue to sleep under a mosquito net every night.
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