Need for vaccination information: Formative research results of Vi PS typhoid vaccine introduction in Karachi, Pakistan

Though mortality and morbidity associated with typhoid fever declined from the use of new generation antimicrobials, incidence of culture proven typhoid fever in children remains as high as 50/1,000 child years in Pakistan. Vaccination may be considered as the best short-term control measure.

We conducted fourteen focus group discussions and 13 in-depth interviews with parents of school-going children, teachers and heads of schools, health care providers, religious and political leaders of the community to identify the modes of communication for a school-based typhoid vaccination program in Karachi.

Typhoid fever was considered a serious illness. Knowledge of preventive methods was very low. For the decision to immunize, parents preferred to consult their family doctor. Face-to-face sessions on health awareness were considered the best source of information followed by the use of mass media. Teachers and heads of schools considered consent from the parents as a key to increase vaccination coverage. Price was an important factor for parents in the decision-making process vaccination in schools. Parents showed reservations for vaccination of their children in the absence of comprehensive information; however, if enough information is provided on adverse events, duration of protection and cost of vaccine, they showed willingness for participation in the vaccination program.

Awareness in the community of typhoid fever and its prevention through vaccination can be increased through a comprehensive program that focuses on its safety, duration of protection and cost to users. The increased awareness in turn will affect typhoid fever vaccination acceptance and hence increased coverage in schools.