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Vaccines for preventing typhoid fever.

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Typhoid vaccines Ty21a and Vi polysaccharide are effective, with Vi-rEPA showing similar efficacy and potentially longer-lasting protection against typhoid fever. These findings aid in understanding vaccine effectiveness for public health strategies.

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Area of Science:

  • Public Health and Epidemiology
  • Vaccinology
  • Infectious Disease Prevention

Background:

  • Typhoid and paratyphoid fevers remain significant global health burdens, particularly in Asia, impacting children and adolescents.
  • Existing vaccines, Ty21a (oral) and Vi polysaccharide (parenteral), are available but not routinely used.
  • New typhoid vaccines, including Vi-rEPA, are under development to improve prevention strategies.

Purpose of the Study:

  • To systematically evaluate the efficacy of available typhoid fever vaccines.
  • To assess the safety and adverse effects associated with typhoid fever vaccines.
  • To compare the effectiveness of different typhoid vaccine types and dosages.

Main Methods:

  • Conducted a comprehensive literature search of multiple databases and trial registries up to June 2013.
  • Included randomized and quasi-randomized controlled trials comparing typhoid vaccines against placebos or other vaccines.
  • Extracted data on vaccine efficacy and adverse events, calculating risk ratios and efficacy percentages with confidence intervals.

Main Results:

  • Ty21a (oral, 3 doses) demonstrated moderate efficacy (35-58%) in the first two years, with no third-year benefit.
  • Vi polysaccharide (injection, 1 dose) showed high efficacy (69% Year 1, 59% Year 2, 55% cumulative 3-year).
  • Vi-rEPA (2 doses) exhibited high efficacy (94% Year 1, 87% Year 2) with no increased adverse events compared to placebo.

Conclusions:

  • Both licensed Ty21a and Vi polysaccharide vaccines are proven to be efficacious in preventing typhoid fever.
  • The unlicensed Vi-rEPA vaccine demonstrates comparable efficacy to licensed vaccines.
  • Vi-rEPA may offer a longer duration of protection, representing a promising advancement in typhoid prevention.