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Vellore Typhoid Vaccine Impact Trial

Phase 4
Recruiting
Conditions
Typhoid Fever
Interventions
Biological: Typhoid conjugate Vaccine
Registration Number
NCT05500482
Lead Sponsor
Christian Medical College, Vellore, India
Brief Summary

This cluster randomised trial will examine the impact of introducing TyphiBEV, a typhoid conjugate vaccine licensed in India, on the incidence of typhoid fever in a high burden urban setting in South India.

Detailed Description

TyphiBEV®, a typhoid conjugate vaccine from Biological E, has been licensed by the Central Drugs Standard Control Organaisation in India based on immunogenicity and safety data. A similar typhoid conjugate vaccine has been demonstrated in large clinical trials to provide 80% vaccine efficacy in Nepal and Bangladesh. The TyphiBEV® has not been similarly evaluated. The demonstration of the impact of a city-scale typhoid conjugate vaccine introduction on the burden of typhoid will aid policy decisions on the use of typhoid conjugate vaccines in the national immunisation program.

After written informed consent, the investigators will establish stimulated passive surveillance in 72,000 individuals between 1 and 30 years of age within the Vellore Demographic Surveillance System to determine the incidence of blood-culture confirmed typhoid fever. Thirty-six thousand surveillance participants between 1 year and 30 years residing in the 30 clusters (areas) randomised to receive the vaccine will receive the vaccine at the beginning of the trial. Those in other areas will receive the same at the end of two years. Using a stimulated passive surveillance approach, those with acute febrile illness will be encouraged to visit study surveillance hospitals. Participants will be evaluated for blood-culture confirmed typhoid fever if they are eligible. The incidence of typhoid among those living in areas assigned to vaccination compared to those whose residence is in areas not designated for vaccination will be used to calculate the impact of the vaccine on disease burden.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
72500
Inclusion Criteria
  • Consent

    • For adults, 18 years and over - they must be willing and competent to provide informed consent
    • For those aged under 18 years, the parent/guardian is willing and competent to provide informed consent, and if the participant is 11 to 18 years of age, informed assent will also be sought,
  • Age:

    • Between 1 and 30 years (i.e., up to 29 years 364 days) at time of recruitment into the surveillance
    • Currently living within the study catchment area with no plans to leave the study area in the next 24 months
Exclusion Criteria
  • For fever surveillance

    o Medical reasons that prevent the participant from complying with study requirements including follow up and testing during illness

  • For vaccination

    • Has received a typhoid vaccine in the previous three years
    • Is known to have an allergy to any vaccine component
    • Nursing mothers, Pregnancy or planning pregnancy around vaccination
    • Receipt of any other vaccine in the past 30 days (temporary exclusion)
    • Febrile illness in the 24 hours before vaccination (temporary exclusion)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Vaccinated armTyphoid conjugate VaccineTyphoid Conjugate Vaccine (TyphiBEV) 0.5 ml as a single dose given intramuscularly to consenting, eligible residents of vaccine clusters
Primary Outcome Measures
NameTimeMethod
Total effectat 24 months of follow up beginning 28 days after vaccine introduction in vaccine clusters.

Number of blood culture confirmed typhoid fever episodes in vaccinated participants from vaccine clusters compared to the number of blood culture confirmed typhoid fever episodes in unvaccinated participants from non-vaccine clusters

Secondary Outcome Measures
NameTimeMethod
Overall effectat 24 months of follow up beginning 28 days after vaccine introduction in vaccine clusters.

The number of blood culture confirmed typhoid fever episodes in participants from vaccine clusters compared to the number of blood culture confirmed typhoid fever episodes in participants from non-vaccine clusters

Effect on all febrile illness requiring healthcare visitsat 24 months of follow up beginning 28 days after vaccine introduction in vaccine clusters.

The number of febrile illness episodes where healthcare is sought among vaccinated participants from vaccine clusters compared to unvaccinated participants from non-vaccine clusters

Safety outcomesSeven days after vaccine receipt

The number and description of solicited and non-solicited adverse events reported within the first seven days after vaccination in the safety subset of vaccine recipients

Effect in children 1 to 14 yearsat 24 months of follow up beginning 28 days after vaccine introduction in vaccine clusters.

The number of blood culture confirmed typhoid fever episodes in vaccinated children between 1 year and 14 years and 364 days from vaccine clusters compared to the number of blood culture confirmed typhoid fever episodes in unvaccinated children between 1 year and 14 years and 364 days from non-vaccine clusters

Trial Locations

Locations (1)

Christian Medical College Vellore

🇮🇳

Vellore, Tamil Nadu, India

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