Typhoid Vaccine
Class: Vaccines
ATC Class: J07AP01
VA Class: IM100
Brands: Typhim Vi, Vivotif
Introduction
Commercially available in US as an oral live, attenuated vaccine (typhoid vaccine live oral Ty21a; Vivotif) and as a parenteral inactivated Vi polysaccharide vaccine (typhoid Vi polysaccharide vaccine; Typhim Vi). Other typhoid vaccines (e.g., inactivated whole-cell vaccines, inactivated protein-conjugated Vi polysaccharide vaccines) may be available in other countries.
Uses for Typhoid Vaccine
Prevention of Typhoid Fever
Prevention of typhoid fever in US travelers planning to visit areas with a recognized risk of exposure to Salmonella enterica serovar Typhi.
Prevention of typhoid fever in individuals with intimate exposure (e.g., household contact) to a known typhoid carrier.
Prevention of typhoid fever in laboratory personnel with frequent contact with Salmonella Typhi bacilli.
Typhoid fever is a potentially severe and occasionally life-threatening, febrile, enteric illness caused by Salmonella Typhi. Usually acquired by ingestion of food and/or water contaminated with feces from individuals who have typhoid fever or are chronic typhoid carriers. Overall case-fatality rate in patients who receive early and appropriate antibacterial treatment is typically <1%; if left untreated, case-fatality rate may be ≥10–20%. Approximately 2–4% of individuals with acute typhoid fever develop a chronic carrier state.
Typhoid fever is uncommon in the US, but endemic in many less well-developed areas of the world that have poor sanitation and primitive water systems. About 22 million cases of typhoid fever and about 200,000 typhoid-related deaths occur annually worldwide. In the US, about 300–400 confirmed cases of typhoid fever are reported annually, almost all in recent travelers to other countries (most commonly southern Asia).
USPHS Advisory Committee on Immunization Practices (ACIP) and CDC state that routine vaccination against typhoid fever not recommended for individuals residing in the US, but preexposure vaccination is recommended for those at high risk of exposure to Salmonella Typhi.
When vaccination against typhoid fever indicated, either typhoid vaccine live oral Ty21a or typhoid Vi polysaccharide vaccine can be used unless contraindicated. Consider that the vaccines have different contraindications (see Contraindications under Cautions) and different minimum age limits for use in children (see Pediatric Use under Cautions). Other factors to consider when selecting a typhoid vaccine include immunization schedule, response time, patient compliance, storage facilities, and immunocompetence of the vaccinee (see Warnings/Precautions under Cautions). Because typhoid vaccine live oral Ty21a is self-administered over a 1-week period and compliance errors (i.e., dosing errors, improper storage) may occur, typhoid Vi polysaccharide vaccine may be preferred if compliance is likely to be a problem.
Efficacy of typhoid vaccine live oral Ty21a and typhoid Vi polysaccharide vaccine appear to be co...
