Typhoid Conjugate Vaccine: A Boon for Endemic Regions

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Apr 23

PMID 38650789

Authors

Nitesh Agarwal

Naveen Gupta

Nishant

Surendra H S

Trayambak Dutta

Manish Mahajan

Affiliations

Soon will be listed here.

Abstract

Typhoid fever has the highest disease burden in countries in low- and middle-income countries, primarily located in Asia and Sub-Saharan Africa. Previous typhoid vaccines such as the live attenuated typhoid (Ty21a) vaccine and Vi (virulence) capsular polysaccharide vaccine had the limitation that they could not be administered with other standard childhood immunizations and were ineffective in children under two years of age. To address these shortcomings of the previous vaccines, typhoid conjugate vaccines (TCVs) were developed and prequalified by the World Health Organization. Cross-reacting material and tetanus toxoid are widely used as carrier proteins in TCVs. According to various studies, TCV has higher efficacy, has a more extended protection period, and is safe and immunogenic in infants as young as six months. This review article aims to comprehensively appraise the data available on TCVs' efficacy, duration of protection, safety, and immunogenicity in endemic regions.

References

Andrews J, Baker S, Marks F, Alsan M, Garrett D, Gellin B . Typhoid conjugate vaccines: a new tool in the fight against antimicrobial resistance. Lancet Infect Dis. 2018; 19(1):e26-e30. DOI: 10.1016/S1473-3099(18)30350-5. View

Hoffman S, LeBoa C, Date K, Haldar P, Harvey P, Shimpi R . Programmatic Effectiveness of a Pediatric Typhoid Conjugate Vaccine Campaign in Navi Mumbai, India. Clin Infect Dis. 2023; 77(1):138-144. PMC: 10320126. DOI: 10.1093/cid/ciad132. View

Jin C, Gibani M, Moore M, Juel H, Jones E, Meiring J . Efficacy and immunogenicity of a Vi-tetanus toxoid conjugate vaccine in the prevention of typhoid fever using a controlled human infection model of Salmonella Typhi: a randomised controlled, phase 2b trial. Lancet. 2017; 390(10111):2472-2480. PMC: 5720597. DOI: 10.1016/S0140-6736(17)32149-9. View

Liu X, Pitzer V, Pollard A, Voysey M . The Design and Analysis of Seroefficacy Studies for Typhoid Conjugate Vaccines. Clin Infect Dis. 2019; 68(Suppl 2):S183-S190. PMC: 6405265. DOI: 10.1093/cid/ciy1119. View

Mogasale V, Maskery B, Ochiai R, Lee J, Mogasale V, Ramani E . Burden of typhoid fever in low-income and middle-income countries: a systematic, literature-based update with risk-factor adjustment. Lancet Glob Health. 2014; 2(10):e570-80. DOI: 10.1016/S2214-109X(14)70301-8. View

Canh D, Lin F, Thiem V, Trach D, Trong N, Mao N . Effect of dosage on immunogenicity of a Vi conjugate vaccine injected twice into 2- to 5-year-old Vietnamese children. Infect Immun. 2004; 72(11):6586-8. PMC: 523060. DOI: 10.1128/IAI.72.11.6586-6588.2004. View

Cartee R, Thanawastien A, Griffin Iv T, Mekalanos J, Bart S, Killeen K . A phase 1 randomized safety, reactogenicity, and immunogenicity study of Typhax: A novel protein capsular matrix vaccine candidate for the prevention of typhoid fever. PLoS Negl Trop Dis. 2020; 14(1):e0007912. PMC: 6964911. DOI: 10.1371/journal.pntd.0007912. View

Shakya M, Colin-Jones R, Theiss-Nyland K, Voysey M, Pant D, Smith N . Phase 3 Efficacy Analysis of a Typhoid Conjugate Vaccine Trial in Nepal. N Engl J Med. 2019; 381(23):2209-2218. PMC: 6785806. DOI: 10.1056/NEJMoa1905047. View

Bhan M, Bahl R, Bhatnagar S . Typhoid and paratyphoid fever. Lancet. 2005; 366(9487):749-62. DOI: 10.1016/S0140-6736(05)67181-4. View

10.

Hancuh M, Walldorf J, Minta A, Tevi-Benissan C, Christian K, Nedelec Y . Typhoid Fever Surveillance, Incidence Estimates, and Progress Toward Typhoid Conjugate Vaccine Introduction - Worldwide, 2018-2022. MMWR Morb Mortal Wkly Rep. 2023; 72(7):171-176. PMC: 9949843. DOI: 10.15585/mmwr.mm7207a2. View

11.

Fraser A, Goldberg E, Acosta C, Paul M, Leibovici L . Vaccines for preventing typhoid fever. Cochrane Database Syst Rev. 2007; (3):CD001261. DOI: 10.1002/14651858.CD001261.pub2. View

12.

Qadri F, Khanam F, Liu X, Theiss-Nyland K, Biswas P, Bhuiyan A . Protection by vaccination of children against typhoid fever with a Vi-tetanus toxoid conjugate vaccine in urban Bangladesh: a cluster-randomised trial. Lancet. 2021; 398(10301):675-684. PMC: 8387974. DOI: 10.1016/S0140-6736(21)01124-7. View

13.

Levine M, Ferreccio C, Abrego P, Martin O, Ortiz E, Cryz S . Duration of efficacy of Ty21a, attenuated Salmonella typhi live oral vaccine. Vaccine. 1999; 17 Suppl 2:S22-7. DOI: 10.1016/s0264-410x(99)00231-5. View

14.

Vadrevu K, Dugyala R, Mahantashetti N, Khalatkar V, Murthy K, Mogre S . Safety, immunogenicity and non-interference of concomitant Typhoid Vi capsular polysaccharide-tetanus toxoid conjugate vaccine (Typbar-TCV®) and measles or measles-mumps-rubella vaccines in 8-9 months-old Indian children. Hum Vaccin Immunother. 2022; 18(7):2150030. PMC: 9762751. DOI: 10.1080/21645515.2022.2150030. View

15.

Aiemjoy K, Seidman J, Charles R, Andrews J . Seroepidemiology for Enteric Fever: Emerging Approaches and Opportunities. Open Forum Infect Dis. 2023; 10(Suppl 1):S21-S25. PMC: 10236506. DOI: 10.1093/ofid/ofad021. View

16.

Parry C, Hien T, Dougan G, White N, Farrar J . Typhoid fever. N Engl J Med. 2002; 347(22):1770-82. DOI: 10.1056/NEJMra020201. View

17.

Nampota-Nkomba N, Nyirenda O, Khonde L, Mapemba V, Mbewe M, Ndaferankhande J . Safety and immunogenicity of a typhoid conjugate vaccine among children aged 9 months to 12 years in Malawi: a nested substudy of a double-blind, randomised controlled trial. Lancet Glob Health. 2022; 10(9):e1326-e1335. PMC: 9380257. DOI: 10.1016/S2214-109X(22)00275-3. View

18.

Steffen R, Behrens R, Hill D, Greenaway C, Leder K . Vaccine-preventable travel health risks: what is the evidence--what are the gaps?. J Travel Med. 2014; 22(1):1-12. DOI: 10.1111/jtm.12171. View

19.

Antillon M, Warren J, Crawford F, Weinberger D, Kurum E, Pak G . The burden of typhoid fever in low- and middle-income countries: A meta-regression approach. PLoS Negl Trop Dis. 2017; 11(2):e0005376. PMC: 5344533. DOI: 10.1371/journal.pntd.0005376. View

20.

Srinivasan M, Sindhu K, John J, Kang G . Opportunities for Typhoid Vaccination in India. Indian Pediatr. 2019; 56(6):453-458. View