Joint WHO/UNICEF statement for typhoid vaccine use in tsunami-affected areas
Systems to be put in place
- Disease surveillance/Early Warning and Response Network (EWARN) to be strengthened if already existent
- Monitoring and evaluation system
- Adverse events following immunization (AEFI) surveillance
- Injection safety and safe waste disposal systems
Annex 1: Characteristics of currently available typhoid vaccines
| Purified Vi polysaccharide | Live attenuated Ty21a | Parenteral inactivated WC vaccine | |
| Commercial name | Typhim®, Typherix® | Vivotif® | NA (information not available) |
| Number of doses required for full immunization | 1 dose i.m. | 1 capsule on day 1—3—5 (total 3 doses) | 2 doses, 4 weeks apart |
| Administration | parenteral | oral | parenteral |
| Earliest onset of protection after full immunization | 14—20 days | 10 days | NA |
| Protective efficacy | 55—75% | 62—79% | 51—67% |
| Revaccination | Revaccination after 3 years | Booster dose every 3 years | Booster every 3 years |
| Use in pregnancy | Only if high risk of infection | Only if high risk of infection | NA |
| Simultaneous administration with other vaccines | Possible at different injection sites; yes for combined hepatitis A-typhoid vaccine | Possible with parenteral vaccines and with oral polio vaccines; not possible with single dose OCV (wait 8 hours) | NA |
| Exclusion criteria | Children under 2 years of age | Children under 5 years of age (liquid formulation for children 2—5 years old); | NA |
| Side-effects | Reaction at injection site; fever, malaise, nausea, itching | Well tolerated; can be given to HIV-positive people provided that CD4 count is above 200/mm3 | Fever, systemic reactions; rare anaphylactic reactions |
| Precautions | Do not inject by intravascular route | Avoid using antibiotics, proguanil or mefloquine during 3 days before and after vaccination. | NA |
| Presentation | Ready to use syringe | 3 enteric-coated capsules | Vials (need syringe and needle) |
| Storage volume | NA | NA | NA |
| Storage | Cold chain (2—8 °C) | Cold chain (2—8 °C) | NA |
| Need for cold chain at immunization point | Relative at ambient temperature (20—25 °C) if the vaccine is used within 24 hours | Vaccine stable for 14 days at 24 °C | NA |
| Manufacturer | Aventis Pasteur: Typhim® GlaxoSmithKline: Typherix® | Berna Biotech, Bern, Switzerland | NA |
| WHO pre- qualification for purchase by UN | no | no | no Not recommended, because of side- effects following immunization |