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Published on: May 19, 2020
Updated recommendations for the use of typhoid vaccine--Advisory Committee on Immunization Practices, United States,
Abstract:
These revised recommendations of the Advisory Committee on Immunization Practices update recommendations published in MMWR in 1994 and include updated information on the two currently available vaccines and on vaccine safety. They also include an update on the epidemiology of enteric fever in the United States, focusing on increasing drug resistance in Salmonella enterica serotype Typhi, the cause of typhoid fever, as well as the emergence of Salmonella serotype Paratyphi A, a cause of paratyphoid fever, against which typhoid vaccines offer little or no protection.
Insights
Updated immunization practices address enteric fever, including typhoid and paratyphoid fevers. Recommendations cover vaccine information and safety, noting rising drug resistance in Salmonella Typhi and the emergence of Salmonella Paratyphi A.
Area of Science:
- Public Health
- Infectious Diseases
- Immunology
Background:
- Revised recommendations for the Advisory Committee on Immunization Practices (ACIP) update 1994 guidelines.
- Focus on enteric fever epidemiology in the United States.
- Growing concern over antimicrobial resistance in Salmonella enterica serotype Typhi.
Purpose of the Study:
- To provide updated information on currently available vaccines for enteric fever.
- To review vaccine safety data.
- To highlight the evolving epidemiology of typhoid and paratyphoid fevers.
Main Methods:
- Review of existing literature and surveillance data.
- Analysis of trends in drug resistance for Salmonella Typhi.
- Assessment of the impact of Salmonella Paratyphi A emergence.
Main Results:
- Updated information on two available vaccines and their safety profiles.
- Increased drug resistance observed in Salmonella enterica serotype Typhi.
- Emergence of Salmonella serotype Paratyphi A, a pathogen not covered by current typhoid vaccines.
Conclusions:
- The recommendations emphasize the need for updated vaccination strategies.
- Growing resistance and new serotypes necessitate ongoing surveillance and vaccine development.
- Public health efforts must adapt to the changing landscape of enteric fever.

