Typhoid Vaccine, Inactivated

Typhoid vaccine, inactivated (killed) is a shot given when there is an expected exposure to the Salmonella typhi bacteria and works by exposing the body to strains of Salmonella typhi so that when exposed to the actual bacteria, the body will already have the ability to fight the attackers. Below is more information on the typhoid vaccine.

Overview

Typhoid vaccine is a drug in the class of bacterial vaccines and is available as Typherix and Typhim Vi among other brand names. It’s been given the brand name Vi capsular polysaccharide (ViCPS) and is quite useful in preventing infections from Salmonella typhi bacteria. The effectiveness of this drug wanes after a few years and needs to be administered again to individuals at high risk of infection.

ViCPS is licensed as safe for use in the United States and is approved by the World Health Organization (WHO) for use to control disease and endemic outbreaks.

ViCPS is not a required vaccination in the United States and other developed countries. The U.S. and other such advanced nations have well-developed sewage disposal systems, which make transmission of Salmonella typhi difficult.

The bacteria is transmitted through contaminated water and food through the fecal-anal route. Salmonella typhi lives in humans only and does not infect any animals. Infection with the bacteria is common in densely populated areas - mainly in third world countries in Asia, Africa, and Latin America. About 21 million people are infected by S. typhi yearly worldwide. It also causes over 220,000 deaths each year worldwide.

It is recommended to get a typhoid vaccine, inactivated if you live in a developed country but are in any one of the following situations.

  • You live with someone who is a carrier of Salmonella typhi bacteria. Some people carry the bacteria and can infect others but never get sick themselves.
  • For some reason, you have long-term exposure to typhoid-causing bacteria.
  • You are working in a laboratory or an environment where exposure to the Salmonella typhi is likely.
  • You plan to travel to an area of the world where infection with Salmonella typhi is common.

Indication

  • Typhoid fever vaccine

Medicine Type

  • Vaccine

Side Effects

ViCPS is well tolerated and does not often have any severe side effects. If one plans to be in a high-risk area, getting the typhoid shot is undoubtedly far much better than waiting to get the disease.

To minimize any adverse effects of the typhoid shot, consult a doctor on what should and should not be eaten before and after getting the medicine. The doctor should give some simple tips so that reactions in the body will not unnecessarily become worse. A doctor should also provide likely side effects so that the patient will know what symptoms after getting the shot constitute an emergency and what does not.

The drug can only be administered by trained medical personnel, so the risk of severe side effects getting worse is minimal, as medical help will be available.

A medical practitioner should be informed immediately if you experience reactions characterized by the following symptoms:

  • Difficulty breathing or swallowing anything
  • Hives
  • Swelling of face, eyes, tongue, lips, inside of nose or throat
  • Itching, especially of feet and hands
  • Sudden, unusual, and severe tiredness or feelings of weakness

Other side effects that are serious and that a doctor should be informed of immediately include the following:

  • Tremors
  • Feeling ill
  • Feeling like you will pass out
  • Swollen glands
  • Itching or rash
  • Body aches
  • Fever

Side effects that are not so serious that resolve themselves in 48 hours include the following:

  • There may be pain, swelling, tenderness, redness or a hard lump at the injection site. These affect more than 10% of recipients of the vaccine.
  • Edema may also occur at the injection site, but this is very rare.

The following not so serious symptoms affect about 1% to 10% of people.

  • Stomach pain
  • Diarrhea
  • Nausea
  • Headache
  • Low fever

Infrequent side effects include

  • Allergic reactions such as anaphylaxis. This affects about one in 10,000 people.

Dosage

The typhoid vaccine, inactivated is recommended for children older than two years and adults who are at risk of contracting typhoid-causing bacteria, Salmonella typhi. Children between one and two can get the anti-typhoid shot if they are going to be exposed to the bacteria. However, children under 12 months of age should never be given this shot.

The recommended doses are as follows:

  • Adults

0.5ml, 1m, once

Another shot with a single dose should be given every two years to people who have continued or repeated exposure to typhoid-causing bacteria.

  • Children, two years and older

0.5mL, 1M, once

Immunization should be repeated in two years in two years with a single dose if the child has continued or repeated exposure to S. typhi.

Efficacy and safety for children younger than two years have not been established for this drug.

Administration Advice

  1. The drug should not be administered intravenously.
  2. The shot is delivered to the deltoid in adults and the anterolateral thigh or deltoid in children.
  3. The shot should be received two weeks before exposure to S. typhi to give the drug time to work.
  4. Records of manufacturer, date, and lot number of the drug administered should be well kept.

Interactions

180 drugs, 551 generic and brand names are known to interact with this typhoid vaccine, inactivated. 177 of these drugs, 545 generic and brand names have moderate interactions with this inactivated vaccine. Three drugs, which comprise of six generic and brand names, have minor interactions with the typhoid shot.

By moderate interaction, it is implied that the two drugs react in a clinically significant way, and should only be used together in exceptional circumstances. By minor interactions, it is meant that the reactions are minimally clinically significant. Measures to monitor such interactions should be applied.

Typhoid vaccine inactivated also has interactions with four diseases.

Here is a list of common medications that are checked when in combination with the inactivated typhoid vaccine:

  • Ambien CR (Zolpidem)
  • Ambien (Zolpidem)
  • Aspirin low strength (Aspirin)
  • Calcium 600 D (calcium/ Vitamin D)
  • Centrum Silver Ultra Men’s (Multivitamin with minerals)
  • Janumet (metformin/sitagliptin)
  • Lantus Solostar (Insulin Glargine)
  • Lipitor (atorvastatin)
  • Malarone (atovaquone/proguanil)
  • Metoprolol Tartrate (Metoprolol)
  • Onglyza (saxagliptin)
  • Prandin (repaglinide)
  • Saxenda (liraglutide)
  • Tetanus-Diphtheria Toxoids adult (Diphtheria toxoid/ tetanus toxoid)
  • Trulicity (dulaglutide)
  • Tylenol (acetaminophen)
  • Vitamin B12 (cyanocobalamin)
  • Xanax (alprazolam)
  • Zetia (ezetimibe)
  • 5-HTP (5-hydroxytryptophan)

Here are the four diseases that react with typhoid vaccine, inactivated.

  1. Infections
  2. 1m injection
  3. Immunodeficiency
  4. Diarrhea

Warnings

  • Pregnancy warnings

Neither have animal studies been undertaken nor is there controlled data on pregnancy in women. The drug falls under AU TGA pregnancy category B2 medicines which have been used by a limited number of women who are pregnant or in the child-bearing age without observing an increase in the frequency of deformation or indirect or direct harm to a human fetus.

It is a U.S. FDA pregnancy category C drug with animal studies during reproduction showing an adverse effect on a fetus. However, there are no adequate well-controlled studies in humans. The use of this drug in pregnant women is recommended when the benefits of using it outweigh the risks.

  • Breastfeeding Warnings

It is not known if the drug is excreted in human milk or animal milk. It should also be used by breastfeeding women, only when there is a high risk of infection.

Storage

Vi polysaccharide typhoid vaccine, (typhoid vaccine, inactivated) is very stable and is not stored using a cold chain, even in tropical climates.

It requires temperatures of between two and eight degrees centigrade for safe storage.

Summary

Typhoid vaccine, inactivated, consists of dead bacteria that the body begins to fight when a shot is given. Since the bacteria are dead, they do not cause disease, but the body gets some practice dealing with such pathogens. Should the immunized person be exposed to the living bacteria, they do not get infected with typhoid because the body’s immune system can fight off the invaders.

However, the vaccine is not 100% effective in protecting against getting infected with typhoid fever. Even after getting the shot, the person must be active in avoiding contaminated food and water. If they are not careful in avoiding contact with S. typhi they could still get typhoid fever.

When one has to travel to high-risk areas, only bottled water should be drunk. Cook food in clean, hygienic places. Fruits and vegetables must be cleaned thoroughly before consumption preferably with allowed disinfectants. By taking extra measure to avoid contaminated food, ingesting S. typhi will be avoided.

It must be noted as well that the vaccine is effective against S. typhi only. Other infections even if bacterial must be treated with appropriate medication. The typhoid vaccine, inactivated can be given safely at the same time with other vaccines. It is, however, recommended that the different vaccines be injected into various limbs.

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Last Reviewed:
December 23, 2017
Last Updated:
December 22, 2017
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