Paratyphoid fever primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Typhoid vaccine is recommended for travelers to areas where there is an increased risk of exposure to S.Typhi.
Indications for use
The typhoid vaccines do not protect against S. Paratyphi infection. Both typhoid vaccines protect 50%–80% of recipients; travelers should be reminded that typhoid immunization is not 100% effective, and typhoid fever could still occur. Two typhoid vaccines are available in the United States:
- Oral live, attenuated vaccine.
- Vi capsular polysaccharide vaccine for intramuscular use.
Vaccine administration
The time required for primary vaccination differs for the 2 vaccines, as do the lower age limits.
Primary vaccination with oral Ty21a vaccine consists of 4 capsules, 1 taken every other day. The capsules should be kept refrigerated (not frozen), and all 4 doses must be taken to achieve maximum efficacy. Each capsule should be taken with cool liquid no warmer than 98.6°F (37°C), approximately 1 hour before a meal. This regimen should be completed 1 week before potential exposure. The vaccine manufacturer recommends that Ty21a not be administered to infants or children aged <6 years.
Primary vaccination with ViCPS consists of one 0.5-mL (25-mg) dose administered intramuscularly. One dose of this vaccine should be given ≥2 weeks before expected exposure. The manufacturer does not recommend the vaccine for infants and children aged <2 years.