Typhoid vaccine

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Typhoid vaccine
Vaccine description
Target disease Typhoid
Type ?
Clinical data
AHFS/Drugs.com Monograph
MedlinePlus a607028
ATC code
  • none
 NYesY (what is this?)  (verify)

Typhoid vaccines are vaccines that prevent typhoid fever.[1] There are two types that are widely available: Ty21a (a live vaccine given by mouth) and Vi capsular polysaccharide vaccine (an injectable subunit vaccine).[1] They are about 30 to 70% effective for the first two years depending on the specific vaccine in question.[2]

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 3 to 7 years;[1] in the United States the vaccine is only recommended in those at high risk such as travellers to areas of the world where the disease is common.[3]

The current vaccines are very safe.[1] Minor side effects may occur at the site of injection,[1] the injectable vaccine is safe in HIV/AIDS and the oral vaccine can be used as long as symptoms are not present.[1] Safety of the oral vaccine during pregnancy is unclear.[1]

The first typhoid vaccines were developed in 1896 by Almroth Edward Wright, Richard Pfeiffer, and Wilhelm Kolle.[4] Due to side-effects newer formulations are currently recommended.[1] Typhoid vaccines are on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[5] The wholesale cost in the developing world is about 4.44 USD per dose as of 2014.[6] In the United States they cost 25 to 50 USD.[7]

Medical uses[edit]

Ty21a and Vi capsular polysaccharide vaccine are effective in reducing typhoid fever with low rates of adverse effects.[2] Newer vaccines such as Vi-rEPA seem promising.[2]

The oral Ty21a vaccine prevented one-third to one-half of typhoid cases in the first two years after vaccination, but had no benefit in the third year,[2] 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. Neither vaccine is effective in children under 5 years old.[8] 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 5 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 4 years.[8]


Depending on the formulation it can be given starting at the age of two or five years old.[1] Three or four doses are then given, with a dose every two days.[1] Different authorities recommend additionally doses every three to seven years,[1] every 3 years for Vi polysaccharide or 7 years for Ty21a.[1]

Ty21a can be used from age two years and older.[1] Boosters are recommended every two years in the United States,[10] the Vi capsular polysaccharide vaccine is licensed for use from age two years and older, and boosters are recommended every five years.[11]


  • Vi polysaccharide vaccine: Typhim Vi (Sanofi Pasteur); Typherix (GSK)[11]
  • Combined hepatitis A/Vi polysaccharide vaccine: ViATIM (Sanofi Pasteur); Hepatyrix (GSK)[11]
  • Ty21a oral vaccine: Vivotif (PaxVax)[11]
  • Activated whole cell vaccine remains available in some parts of the developing world as of 2008.[1]


  1. ^ a b c d e f g h i j k l m n o p q "Typhoid vaccines: WHO position paper" (PDF). Releve epidemiologique hebdomadaire / Section d'hygiene du Secretariat de la Societe des Nations = Weekly epidemiological record / Health Section of the Secretariat of the League of Nations. 83 (6): 49–59. 8 February 2008. PMID 18260212. Archived (PDF) from the original on 2 April 2015. 
  2. ^ a b c d Anwar, E; Goldberg, E; Fraser, A; Acosta, CJ; Paul, M; Leibovici, L (2 January 2014). "Vaccines for preventing typhoid fever". The Cochrane Database of Systematic Reviews. 1: CD001261. doi:10.1002/14651858.CD001261.pub3. PMID 24385413. 
  3. ^ "Typhoid VIS". CDC. 2012-05-29. Archived from the original on 8 December 2015. Retrieved 15 December 2015. 
  4. ^ Flower, Darren R. (2008). Bioinformatics for Vaccinology. Chichester: John Wiley & Sons. pp. 40–41. ISBN 9780470699829. Archived from the original on 2015-12-22. 
  5. ^ "WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016. 
  6. ^ "Vaccine, Typhoid". International Drug Price Indicator Guide. Retrieved 6 December 2015. 
  7. ^ Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 317. ISBN 9781284057560. 
  8. ^ a b Szu, SC (November 2013). "Development of Vi conjugate - a new generation of typhoid vaccine". Expert review of vaccines. 12 (11): 1273–86. doi:10.1586/14760584.2013.845529. PMID 24156285. 
  9. ^ Lin, FY; Ho, VA; Khiem, HB; Trach, DD; Bay, PV; Thanh, TC; Kossaczka, Z; Bryla, DA; Shiloach, J; Robbins, JB; Schneerson, R; Szu, SC (26 April 2001). "The efficacy of a Salmonella typhi Vi conjugate vaccine in two-to-five-year-old children". The New England Journal of Medicine. 344 (17): 1263–9. doi:10.1056/nejm200104263441701. PMID 11320385. 
  10. ^ "Archived copy". Archived from the original on 2015-12-08. Retrieved 2015-12-15. 
  11. ^ a b c d Helfand, Carley. PaxVax joins the marketed vaccines club with Crucell typhoid buy. FierceVaccines. Archived from the original on 2015-04-02.