A Cluster-Randomized Effectiveness Trial of Vi Typhoid Vaccine in India

• Published in: The New England journal of medicine Vol. 361; no. 4; pp. 335 - 344
• Main Authors: Sur, Dipika, Ochiai, R. Leon, Bhattacharya, Sujit K, Ganguly, Nirmal K, Ali, Mohammad, Manna, Byomkesh, Dutta, Shanta, Dutta, Dharitri, Donner, Allan, Kanungo, Suman, Park, Jin Kyung, Puri, Mahesh K, Kim, Deok Ryun, Bhaduri, Barnali, Acosta, Camilo J, Clemens, John D
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 23.07.2009
• Subjects: Adolescent; Adult; Antibodies, Bacterial - blood; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Child; Child, Preschool; Children & youth; Developing Countries; General aspects; Hepatitis A Vaccines - adverse effects; Human bacterial diseases; Humans; Immunization; Immunoglobulin G - blood; India; Infectious diseases; Medical sciences; Paratyphoid Fever - epidemiology; Polysaccharides, Bacterial - adverse effects; Polysaccharides, Bacterial - immunology; Population Surveillance; Public health; Salmonella typhi - immunology; Treatment Outcome; Typhoid; Typhoid Fever - epidemiology; Typhoid Fever - immunology; Typhoid Fever - prevention & control; Typhoid-Paratyphoid Vaccines - adverse effects; Typhoid-Paratyphoid Vaccines - immunology; Vaccines; Asia; India; Infection; Medicine; Randomization; Cluster randomised trial; Efficiency; Vaccination; Bacteriosis; Digestive diseases; Clinical trial; Salmonellosis; Vaccine; Typhoid
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa0807521

Typhoid remains an important cause of illness and death in the developing world. In this phase 4 trial in Kolkata, India, 37,673 subjects were vaccinated with either Vi typhoid vaccine or hepatitis A vaccine. The Vi vaccine was approximately 61% effective in preventing typhoid infection in vaccine recipients and was 44% effective in unvaccinated members of the same clusters as the Vi-vaccine recipients, suggesting that Vi vaccination has indirect benefits for those in close contact with vaccine recipients. The Vi vaccine was approximately 61% effective in preventing typhoid infection in vaccine recipients and was 44% effective in unvaccinated members of the same clusters. Vi vaccination has indirect benefits for those in close contact with vaccine recipients. Typhoid fever, caused by Salmonella enterica serotype Typhi ( S. Typhi), results in an estimated 216,000 to 600,000 deaths annually, almost all in developing countries. 1 , 2 Among licensed, newer-generation typhoid vaccines, the injectable Vi polysaccharide vaccine has several characteristics that make it attractive for use in developing countries. Given in a single dose, the Vi vaccine is sold at prices as low as 50 cents per dose. Moreover, the Vi vaccine is produced by two international manufacturers and several manufacturers in developing countries, which have licensed it for persons 2 years of age or older. 3 – 5 Despite a World . . .