Typhoid polysaccharide Vaccine

Indications

Typhoid polysaccharide Vaccine is used for: This vaccine is indicated for, active immunization against typhoid fever, for adults and children two years of age or older. Selective immunization with typhoid vaccine is recommended for the following: Travellers to high endemic areas, Household contact of carriers, Healthcare personnel, Police, Armed forces and such other regimented personnel, Laboratory workers who work with Salmonella typhi.

Adult Dose

Intramuscular Active immunisation against typhoid fever caused by Salmonella typhi Adult: A single dose of 0.5 ml is recommended for both adults. Subjects who remain at risk of typhoid fever should be given a single booster dose of the vaccine with an interval of not more than 3 years.

Child Dose

Typhoid Fever Prophylaxis Indicated for selective immunization against typhoid fever for people traveling to endemic areas Child: A single dose of 0.5 ml is recommended for children 2 years of age or older. Subjects who remain at risk of typhoid fever should be given a single booster dose of the vaccine with an interval of not more than 3 years.

Renal Dose

Administration

This vaccine is for intramuscular injection only. Do not inject intravenously. Vaxphoid should be given intramuscularly in the deltoid and children should be injected intramuscularly either in the deltoid or the vastus lateralis. It should not be injected into the gluteal areas where there may be a nerve trunk. Vaxphoid injection should be administered with caution to subjects with thrombocytopenia or bleeding disorders since bleeding may occur following an intramuscular administration to these subjects. Following injection, firm pressure should be applied to the site (without rubbing) for at least two minutes.

Contra Indications

The vaccine protects against typhoid fever caused by Salmonella typhi. Protection is not conferred against paratyphoid fever or illness caused by non-invasive Salmonella. Typhoid vaccine should not be administered to subjects with known hypersensitivity to any component of the vaccine or to subjects having shown signs of hypersensitivity after previous Typhoid vaccine administration, or after any other vaccine containing Vi polysaccharide Salmonella typhi antigens. It may be expected that in patients receiving immunosuppressive treatment or patients with immunodeficiency, an adequate response may not be achieved. The administration of Typhoid vaccine should be postponed in subjects suffering from acute severe febrile illness.

Precautions

Not for treatment of typhoid fever. Vaccination may not provide full proetction thus, travellers should be advised to take all necessary precautions to avoid contact or ingestion of potentially contaminated food or water sources. IM admin: Caution when used in patients with a history of bleeding disorders, patients on anticoagulant treatment or severely immunocompromised patients. Pregnancy: the effect of Typhoid vaccine on fetal development or reproduction capacity has not been evaluated. Typhoid vaccine should only be used during pregnancy when there is a high risk of infection. Lactation: Not known if excreted in breast ; use caution

Pregnancy-Lactation

Pregnancy Category: C Lactation: Not known if excreted in breast ; use caution

Interactions

Concurrent use with antibiotics or immunoglobulins may reduce the efficacy of typhoid vaccine. Mefloquine may increase the efficacy of typhoid vaccine. May reduce the diagnostic effect of tuberculin tests. Potentially Fatal: Concurrent use with immunosuppressants may increase the adverse effects of live vaccines.

Adverse Effects

Side effects of Typhoid polysaccharide Vaccine : >10% Fever (2-32%), Malaise (4-24%), Headache (16-20%), Soreness (16%), Induration (5-15%), General aches (1-13%) 1-10% Abdominal pain (6.4%), Nausea (<8%), Diarrhea (2.9%), Vomiting (1.5%), Skin rash (1%), Pruritus (<8%), Myalgia (3-7%) <1% Cervical pain, Diarrhea, Flu-like syndrome, Arthralgia, Abdominal pain, Loss of consciousness, Perforated jejunum, Weakness

Mechanism of Action

Live attenuateTY21a strain lacks enzyme UDP-4-galactose epimerase, which causes lipopolysaccharide to be synthesized under conditions that induce bacterial autolys; the avirulent strain produces enough lipopolysaccharide to evoke a protective immune response. Conveys active immunity via stimulation of production of endogenously produced antibodies