Ty21a

Last updated
Ty21a
Vivotif-typhoid-live-oral-vaccine.JPG
Vaccine description
Target Typhoid
Vaccine type Attenuated
Clinical data
Trade names Vivotif
Routes of
administration
Oral
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only)
  • CA:Unscheduled
  • UK: POM (Prescription only)
  • US: ℞-only
Identifiers
CAS Number
   (verify)

Ty21a is a live attenuated bacterial vaccine that protects against typhoid. First licensed in Europe in 1983 and in the United States in 1989, it is an orally administered, live-attenuated Ty2 strain of S. Typhi in which multiple genes, including the genes responsible for the production of Vi, have been deleted so as to render it harmless but nevertheless immunogenic. It is one of the three typhoid vaccines currently recommended by the World Health Organization (the other two being the Typhoid Conjugate Vaccine (TCV) and Vi capsular polysaccharide vaccine). [1]

Contents

The vaccine is given by mouth. The vaccine is presented either as enteric coated capsules or as a liquid suspension. The vaccine must be stored at 2 to 8 °C, but will retain its potency for 14 days at 25 °C. [2]

Medical uses

The vaccine offers a statistically significant protection for the first seven years. [3] The vaccine is most commonly used to protect travelers to endemic countries, but some agencies claim that the vaccine could be used in large scale public prevention programs. [2]

The Vi polysaccharide vaccine is also effective at preventing typhoid fever. [3]

Dosing

The recommended dose varies according to country and preparation. At least three doses are required for protection. [4]

In the US and Canada, an initial course of 4 doses on alternate days is recommended. Full protection is achieved 7 days after the last dose. In the US, a booster dose is recommended after 5 years. In Canada, a booster dose is recommended after 7 years.[ citation needed ]

In Australia and Europe, an initial course of 3 doses on alternate days is recommended. Protection is achieved 7 days after the last dose. A booster dose is recommended every 3 years for people living in endemic areas, but every year for people traveling from non-endemic to endemic areas. [5]

Side effects

Side effects of this vaccine are mild and rare. [3] [4]

Trade names

Research

Ty21a may also provide some degree of protection against paratyphoid fever A and B. [7] This cross-protection by a typhoid vaccine is most likely due to O antigens shared between different S. enterica serotypes. [8]

A newer Vi-rEPA vaccine is being tested for preventing typhoid fever. It has a similar level of protection, but the protection may last longer with this newer vaccine. [3]

Related Research Articles

<span class="mw-page-title-main">Typhoid fever</span> Disease caused by the bacteria Salmonella Typhi

Typhoid fever, also known simply as typhoid, is a disease caused by Salmonella enterica serotype Typhi bacteria, also called Salmonella typhi. Symptoms vary from mild to severe, and usually begin six to 30 days after exposure. Often there is a gradual onset of a high fever over several days. This is commonly accompanied by weakness, abdominal pain, constipation, headaches, and mild vomiting. Some people develop a skin rash with rose colored spots. In severe cases, people may experience confusion. Without treatment, symptoms may last weeks or months. Diarrhea may be severe, but is uncommon. Other people may carry it without being affected, but are still contagious. Typhoid fever is a type of enteric fever, along with paratyphoid fever. Salmonella enterica Typhi is believed to infect and replicate only within humans.

<span class="mw-page-title-main">Vaccine</span> Pathogen-derived preparation that provides acquired immunity to an infectious disease

A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins. The agent stimulates the body's immune system to recognize the agent as a threat, destroy it, and recognize further and destroy any of the microorganisms associated with that agent that it may encounter in the future.

<span class="mw-page-title-main">Conjugate vaccine</span> Type of vaccine

A conjugate vaccine is a type of subunit vaccine which combines a weak antigen with a strong antigen as a carrier so that the immune system has a stronger response to the weak antigen.

<span class="mw-page-title-main">Meningococcal disease</span> Often life-threatening bacterial infection

Meningococcal disease describes infections caused by the bacterium Neisseria meningitidis. It has a high mortality rate if untreated but is vaccine-preventable. While best known as a cause of meningitis, it can also result in sepsis, which is an even more damaging and dangerous condition. Meningitis and meningococcemia are major causes of illness, death, and disability in both developed and under-developed countries.

<span class="mw-page-title-main">Paratyphoid fever</span> Bacterial infection caused by one of the three types of Salmonella enterica

Paratyphoid fever, also known simply as paratyphoid, is a bacterial infection caused by one of three types of Salmonella enterica. Symptoms usually begin 6–30 days after exposure and are the same as those of typhoid fever. Often, a gradual onset of a high fever occurs over several days. Weakness, loss of appetite, and headaches also commonly occur. Some people develop a skin rash with rose-colored spots. Without treatment, symptoms may last weeks or months. Other people may carry the bacteria without being affected; however, they are still able to spread the disease to others. Typhoid and paratyphoid are of similar severity. Paratyphoid and typhoid fever are types of enteric fever.

An attenuated vaccine is a vaccine created by reducing the virulence of a pathogen, but still keeping it viable. Attenuation takes an infectious agent and alters it so that it becomes harmless or less virulent. These vaccines contrast to those produced by "killing" the pathogen.

<span class="mw-page-title-main">Hepatitis A vaccine</span> Vaccine to prevent hepatitis A

Hepatitis A vaccine is a vaccine that prevents hepatitis A. It is effective in around 95% of cases and lasts for at least twenty years and possibly a person's entire life. If given, two doses are recommended beginning after the age of one. It is given by injection into a muscle. The first hepatitis A vaccine was approved in the European Union in 1991, and the United States in 1995. It is on the World Health Organization's List of Essential Medicines.

<span class="mw-page-title-main">Hib vaccine</span> Haemophilus influenzae type B vaccine

The Haemophilus influenzae type B vaccine, also known as Hib vaccine, is a vaccine used to prevent Haemophilus influenzae type b (Hib) infection. In countries that include it as a routine vaccine, rates of severe Hib infections have decreased more than 90%. It has therefore resulted in a decrease in the rate of meningitis, pneumonia, and epiglottitis.

The Vi capsular polysaccharide vaccine is a typhoid vaccine recommended by the World Health Organization for the prevention of typhoid. The vaccine was first licensed in the US in 1994 and is made from the purified Vi capsular polysaccharide from the Ty2 Salmonella Typhi strain; it is a subunit vaccine.

<span class="mw-page-title-main">Rabies vaccine</span> Vaccines to prevent rabies in humans and animals

The rabies vaccine is a vaccine used to prevent rabies. There are several rabies vaccines available that are both safe and effective. Vaccinations must be administered prior to rabies virus exposure or within the latent period after exposure to prevent the disease. Transmission of rabies virus to humans typically occurs through a bite or scratch from an infectious animal, but exposure can occur through indirect contact with the saliva from an infectious individual.

NmVac4-A/C/Y/W-135 is the commercial name for a polysaccharide vaccine that protects against meningococcal meningitis caused by Neisseria meningitidis, specifically the serotypes A, C, Y, and W-135. This vaccine is part of a broader group of meningococcal vaccines. It is especially formulated for use in developing countries, aimed at protecting populations during meningitis outbreaks, particularly in high-risk regions like the African meningitis belt.

<span class="mw-page-title-main">Diphtheria vaccine</span> Vaccine against diphtheria

Diphtheria vaccine is a toxoid vaccine against diphtheria, an illness caused by Corynebacterium diphtheriae. Its use has resulted in a more than 90% decrease in number of cases globally between 1980 and 2000. The first dose is recommended at six weeks of age with two additional doses four weeks apart, after which it is about 95% effective during childhood. Three further doses are recommended during childhood. It is unclear if further doses later in life are needed.

<span class="mw-page-title-main">Cholera vaccine</span> Vaccine to prevent cholera

A cholera vaccine is a vaccine that is effective at reducing the risk of contracting cholera. The recommended cholera vaccines are administered orally to elicit local immune responses in the gut where the intestinal cells produce antibodies against the cholera microbe. This immune response was poorly achieved with the injectable vaccines that were used until the 1970s. The first effective oral cholera vaccine was Dukoral, developed in Sweden in the 1980s. For the first six months after vaccination it provides about 85% protection, which decreases to approximately 60% during the first two years. When enough of the population is immunized, it may protect those who have not been immunized thereby increasing the total protective impact to more than 90 %.

Meningococcal vaccine refers to any vaccine used to prevent infection by Neisseria meningitidis. Different versions are effective against some or all of the following types of meningococcus: A, B, C, W-135, and Y. The vaccines are between 85 and 100% effective for at least two years. They result in a decrease in meningitis and sepsis among populations where they are widely used. They are given either by injection into a muscle or just under the skin.

<span class="mw-page-title-main">Typhoid vaccine</span> Vaccines that prevent typhoid fever

Typhoid vaccines are vaccines that prevent typhoid fever. Several types are widely available: typhoid conjugate vaccine (TCV), Ty21a and Vi capsular polysaccharide vaccine (ViPS). They are about 30 to 70% effective in the first two years, depending on the specific vaccine in question. The Vi-rEPA vaccine is efficacious in children.

<span class="mw-page-title-main">Yellow fever vaccine</span> Vaccine that protects against yellow fever

Yellow fever vaccine is a vaccine that protects against yellow fever. Yellow fever is a viral infection that occurs in Africa and South America. Most people begin to develop immunity within ten days of vaccination and 99% are protected within one month, and this appears to be lifelong. The vaccine can be used to control outbreaks of disease. It is given either by injection into a muscle or just under the skin.

<span class="mw-page-title-main">Cocooning (immunization)</span> Vaccination strategy

Cocooning, also known as the Cocoon Strategy, is a vaccination strategy to protect infants and other vulnerable individuals from infectious diseases by vaccinating those in close contact with them. If the people most likely to transmit an infection are immune, their immunity creates a "cocoon" of protection around the newborn.

<span class="mw-page-title-main">Tetanus vaccine</span> Vaccines used to prevent tetanus

Tetanus vaccine, also known as tetanus toxoid (TT), is a toxoid vaccine used to prevent tetanus. During childhood, five doses are recommended, with a sixth given during adolescence.

<span class="mw-page-title-main">Edward Thomas Ryan</span> American microbiologist

Edward Thomas Ryan is an American microbiologist, immunologist, and physician at Harvard University and Massachusetts General Hospital. Ryan served as president of the American Society of Tropical Medicine and Hygiene from 2009 to 2010. Ryan is Professor of Immunology and Infectious Diseases at the Harvard T.H. Chan School of Public Health, Professor of Medicine at Harvard Medical School, and Director of Global Infectious Diseases at the Massachusetts General Hospital. Ryan's research and clinical focus has been on infectious diseases associated with residing in, immigrating from, or traveling through resource-limited areas. Ryan is a Fellow of the American Society of Microbiology, the American Society of Tropical Medicine and Hygiene, the American College of Physicians, and the Infectious Diseases Society of America.

<span class="mw-page-title-main">Vaccine ingredients</span> Ingredients used in a vaccine dose

A vaccine dose contains many ingredients very little of which is the active ingredient, the immunogen. A single dose may have merely nanograms of virus particles, or micrograms of bacterial polysaccharides. A vaccine injection, oral drops or nasal spray is mostly water. Other ingredients are added to boost the immune response, to ensure safety or help with storage, and a tiny amount of material is left-over from the manufacturing process. Very rarely, these materials can cause an allergic reaction in people who are very sensitive to them.

References

  1. "WHO position paper on typhoid Vaccines, March 2018" (PDF). World Health Organization. March 2018. Retrieved 2019-05-05.
  2. 1 2 World Health Organization (February 2008). "Typhoid vaccines: WHO position paper" (PDF). Relevé Épidémiologique Hebdomadaire. 83 (6): 49–59. PMID   18260212.
  3. 1 2 3 4 Milligan R, Paul M, Richardson M, Neuberger A (May 2018). "Vaccines for preventing typhoid fever". The Cochrane Database of Systematic Reviews. 2018 (5): CD001261. doi:10.1002/14651858.CD001261.pub4. PMC   6494485 . PMID   29851031.
  4. 1 2 "World Health Organization Information sheet: Observed rate of vaccine reactions- Typhoid Vaccine" (PDF). WHO. April 2014.
  5. Salisbury D, Ramsay M, Noakes K (2006-12-11). ""Chapter 33: Typhoid"" (PDF). Immunisation against infectious disease. Department of Health. p. 418. ISBN   0-11-322528-8.[ permanent dead link ]
  6. "Our Products". Emergent BioSolutions. Retrieved 20 February 2023.
  7. Levine MM, Ferreccio C, Black RE, Lagos R, San Martin O, Blackwelder WC (July 2007). "Ty21a live oral typhoid vaccine and prevention of paratyphoid fever caused by Salmonella enterica Serovar Paratyphi B". Clinical Infectious Diseases. 45 (Suppl 1): S24 –S28. doi: 10.1086/518141 . PMID   17582564.
  8. Whitaker JA, Franco-Paredes C, del Rio C, Edupuganti S (2009). "Rethinking typhoid fever vaccines: implications for travelers and people living in highly endemic areas". Journal of Travel Medicine. 16 (1): 46–52. doi: 10.1111/j.1708-8305.2008.00273.x . PMID   19192128.