typhoid vaccine (Vivotif Bernia)

Indications

• promotes active immunity to typhoid fever for patients exposed to a typhoid carrier or foreign travel to endemic area (80% effective in children under 5)
• herd immunity effect (44% effective)
• typhoid conjugate vaccine recommended for infants & children > 6 months of age in typhoid-endemic countries (WHO)

Contraindications

• acute infection
• previous sensitivity to typhoid vaccine
• previous adverse reaction to parenteral typhoid vaccine is not a contraindication to use of oral vaccine

Caution:

• use in pregnancy & immunodeficiency only when clearly needed

Dosage

Oral: typhoid live virus vaccine

• adults & children > 6 years of age
• primary immunization:
  • one capsule on alternate days (4 capsules)
  • take 1 hour after meals with water
• booster: repeat primary schedule at 5 year intervals

Parenteral: typhoid polysaccharide vaccine

• primary immunization (Typhim Vi)
  • adults & children >= 2 years of age
  • 25 ug (0.5 mL) IM
• booster: repeat at 2 year intervals

Pharmacokinetics

Oral: Onset of immunity within 1 week; duration 5 years.

Injection:

• primary vaccination may be accomplished with a single injection
• duration of immunity 2 years

Adverse effects

oral

• most common (1-10%)
  • abdominal discomfort, stomach cramps, diarrhea, nausea/ vomiting, skin rash
• uncommon (<1%)
  • anaphylactic reaction

injection

• common (> 10%)
  • local tenderness, pain, erythema, malaise
• less common (1-10%)
  • induration, myalgia, nausea, headache

Drug interactions

• avoid simultaneous administration of other vaccines which may cause local or systemic reactions
• systemic antibiotics & antimalarials may inhibit vaccine response

More general terms

• vaccine

More specific terms

• typhoid conjugate vaccine
• typhoid live virus vaccine (Vivotif)
• typhoid polysaccharide vaccine (Typhim VI)

Additional terms

• typhoid (enteric) fever