Typhoid vaccines are vaccines that prevent typhoid fever.[1][2][3] Several types are widely available: typhoid conjugate vaccine (TCV), Ty21a (a live oral vaccine) and Vi capsular polysaccharide vaccine (ViPS) (an injectable subunit vaccine). They are about 30 to 70% effective in the first two years, depending on the specific vaccine in question. The Vi-rEPA vaccine has been shown to be efficacious in children.[4]
The World Health Organization (WHO) recommends vaccinating all children in areas where the disease is common.[1] Otherwise they recommend vaccinating those at high risk.[1] Vaccination campaigns can also be used to control outbreaks of disease.[1] Depending on the vaccine, additional doses are recommended every three to seven years.[1] In the United States the vaccine is only recommended in those at high risk such as travelers to areas of the world where the disease is common.[5]
The vaccines available as of 2018 are very safe.[1] Minor side effects may occur at the site of injection.[1] The injectable vaccine is safe in people with HIV/AIDS and the oral vaccine can be used as long as symptoms are not present.[1] While it has not been studied during pregnancy, the non-live vaccines are believed to be safe while the live vaccine is not recommended.[1]
Ty21a, the Vi capsular polysaccharide vaccine, and Vi-rEPA are effective in reducing typhoid fever with low rates of adverse effects.[4] Newer vaccines such as Vi-TT (PedaTyph) are awaiting[when?] field trials to demonstrate efficacy against natural exposure.[4]
The oral Ty21a vaccine prevents around one-half of typhoid cases in the first three years after vaccination. The injectable Vi polysaccharide vaccine prevented about two-thirds of typhoid cases in the first year and had a cumulative efficacy of 55% by the third year. The efficacy of these vaccines has only been demonstrated in children older than two years.[4]Vi-rEPA vaccine, a new conjugate form of the injectable Vi vaccine, may be more effective and prevents the disease in many children under the age of five years.[9] In a trial in 2-to-5-year-old children in Vietnam, the vaccine had more than 90 percent efficacy in the first year and protection lasted at least four years.[10]
Schedule
Depending on the formulation it can be given starting at the age of two (ViPS), six (Ty21a), or six months (TCV).[1]
^World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
^World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.