International Journal of Community Medicine and Public Health | September 2021 | Vol 8 | Issue 9 Page 4273 International Journal of Community Medicine and Public Health Tabassum F et al. Int J Community Med Public Health. 2021 Sep;8(9):4273-4279 http://www.ijcmph.com pISSN 2394-6032 | eISSN 2394-6040 Original Research Article Programmatic evaluation of a school-based typhoid vaccination campaign: findings of qualitative research Farhana Tabassum 1 *, Shanila Nooruddin 1 , Atif Habib 1,2 , Noshad Ali 2 , Imtiaz Hussain 1 , Alfred Pach 3 , Zahid Memon 1 , Sajid Soofi 1,2 , Zulfiqar A. Bhutta 1 INTRODUCTION Typhoid fever, a disease caused by the bacterium, Salmonella enterica serotype typhi (S. typhi), continues to be a serious public health problem in many developing countries. Humans are the only source of the S. typhi infection as it spreads by fecal-oral route through contaminated food and water. Typhoid is characterized by persistent fever, abdominal pain, malaise and often causes prolonged illness. In about 10-15% cases it leads to serious complications such as hypotensive shock, gut perforation and gastrointestinal hemorrhage. 1 Preventive measures include improvement in water and sanitation systems as well as in general living conditions yet requiring a large investment and are far off goals in typhoid endemic countries. Globally, typhoid fever is an important cause of morbidity and mortality, with an estimated 12-33 million cases leading to 216,000-600,000 deaths yearly; with ABSTRACT Background: Globally, typhoid fever is a vaccine preventable infectious disease with significant morbidity and mortality. Apart from expanded program on immunization center, other alternative and accessible venues were needed for this vaccine like schools. The purpose of this study was to identify the factors influencing acceptance and rejection of participation in school-based typhoid vaccination program in target communities in Karachi. Methods: A qualitative study was conducted, 46 in-depth interviews were conducted with parents, teachers and administrators in the schools where the typhoid vaccine was provided. NVivo was utilized for data coding and themes were derived along with WHO’s analytical framework, vaccine hesitancy, that is, confidence, convenience and complacency, in responses to the vaccination. Results: Participants described confidence as a key factor that largely rooted their perceptions and attitudes related to the vaccination program. Stakeholders showed their concerns about affordability, safety and effectiveness and convenience of the vaccine’s delivery to the students. Satisfied participants from the school-based program showed lack of trust in quality of vaccine and vaccination procedures. Conclusions: Our findings indicate the importance of providing adequate information on vaccination through multiple communication channels, sustained social mobilization programs including community engagement. Addressing concerns through dialogic interactions were crucial for motivation and acceptance of the vaccination program. Keywords: School, Typhoid vaccine, Vaccination campaign 1 Center of Excellence in Women and Child Health, 2 Department of Paediatrics and Child Health, The Aga Khan University, Pakistan 3 RENEW International, Plainfield, New Jersey, USA Received: 28 June 2021 Accepted: 05 August 2021 *Correspondence: Farhana Tabassum, E-mail: Farhana.tabassum@aku.edu Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: https://dx.doi.org/10.18203/2394-6040.ijcmph20213526