Impact of the COVID-19 pandemic and typhoid conjugate vaccine introduction on typhoid fever in Nepal.

S. Typhi blood culture positivity declined sharply during the pandemic before TCV introduction. The subsequent rollout of TCV substantially reduced typhoid burden in vaccine-eligible children; however, rising cases among older, vaccine-ineligible populations following the relaxation of pandemic measures highlights the need for additional control measures such as improved water and sanitation infrastructure and broader age eligibility for typhoid vaccination.