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