Q. Who should be given the typhoid vaccine?
Typhoid vaccine is not a part of EPI schedule. But typhoid is an endemic disease in India with estimated incidence of 5 million cases per annum. Presently multidrug resistant typhoid is common with resistance to ampicillin, trimethoprim, chloramphenicol, and furazolidone. MIC for quinolones has gone up & very soon one will start seeing resistance to quinolones too. That will leave only 3rd generation cephlosporins to be used in such cases. Besides, multidrug resistant typhoid has higher morbidity & mortality.

The currently available vaccines are safe and efficacious especially the Vi antigen vaccine and the oral ty21a vaccine. Hence most pediatricians recommend the vaccine to be given routinely to all children but for the cost. It is a vaccine to be recommended with high priority to all those who can afford it. Besides it must be given to all food handlers, travelers to endemic areas, those who eat outside open food frequently. It should also be given to those who have suffered typhoid fever as typhoid does not lead to protective immunity & relapses are known to occur. In such cases, it is given 4 weeks after complete recovery from typhoid fever.

Oral ty21a vaccine is contraindicated in immune compromised host as it is a live vaccine. However whole cell killed vaccine & Vi antigen vaccine can be given to such patients. Any vaccine is deferred in a very sick child. Mild illness like URTI or mild diarrhea is not a contraindication for any vaccine. Antibiotics that act against S. typhi should not be given 5 days before, during & after vaccination with oral ty21a vaccine. Lastly, any child who has shown severe reactions to previous typhoid vaccine should not be given the same vaccine again.

Q. What if the patient comes late for the vaccine?
As typhoid can occur at any age, no age is bar from giving the vaccine. If patient has not completed in time the schedule of 2 doses of whole cell killed vaccine or of 3 capsules of oral ty21a vaccine, the course should be repeated, as there is no T-cell memory induced by typhoid vaccines.

Can typhoid vaccine be given along with other vaccine?
Typhoid vaccine can be given along with other vaccine using separate syringe and separate site. Such need arises for travelers to endemic area who need to take typhoid vaccine as well as Hepatitis A vaccine at the same time.

Also See Articles On " TYPHOID FEVER "

                             " TYPHOID (ENTERIC FEVER) "

Last created on 23-02-2001
Last updated on 03-05-2007