Ty21a: Difference between revisions
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{{Short description|Typhoid vaccine}} |
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{{Drugbox |
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{{Infobox drug |
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| verifiedrevid = |
| verifiedrevid = 449938078 |
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| image = |
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| image = Vivotif-typhoid-live-oral-vaccine.JPG |
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<!-- |
<!--Vaccine data--> |
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| type = vaccine |
| type = vaccine |
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| target = [[Typhoid]] |
| target = [[Typhoid]] |
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| vaccine_type = |
| vaccine_type = attenuated |
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<!--Clinical data--> |
<!--Clinical data--> |
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| tradename = |
| tradename = Vivotif |
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| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X --> |
| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X --> |
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| pregnancy_US = <!-- A / B / C / D / X --> |
| pregnancy_US = B <!-- A / B / C / D / X --> |
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| pregnancy_category = |
| pregnancy_category = |
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| legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled--> |
| legal_AU = S4 <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled--> |
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| legal_CA = <!-- Schedule I, II, III, IV, V, VI, VII, VIII --> |
| legal_CA = Unscheduled <!-- Schedule I, II, III, IV, V, VI, VII, VIII --> |
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| legal_UK = <!-- GSL, P, POM, CD, or Class A, B, C --> |
| legal_UK = POM <!-- GSL, P, POM, CD, or Class A, B, C --> |
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| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V --> |
| legal_US = Rx-only <!-- OTC / Rx-only / Schedule I, II, III, IV, V --> |
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| legal_status = |
| legal_status = |
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| routes_of_administration = |
| routes_of_administration = Oral |
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<!--Identifiers--> |
<!--Identifiers--> |
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| CAS_number_Ref = {{cascite|correct|??}} |
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| CAS_number = |
| CAS_number = 1704529-13-4 |
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| ATC_prefix = J07 |
| ATC_prefix = J07 |
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| ATC_suffix = AP01 |
| ATC_suffix = AP01 |
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| PubChem = |
| PubChem = |
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| DrugBank_Ref = {{drugbankcite|correct|drugbank}} |
| DrugBank_Ref = {{drugbankcite|correct|drugbank}} |
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| DrugBank = |
| DrugBank = |
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<!--Chemical data--> |
<!--Chemical data--> |
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}} |
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'''Ty21a''' is a live [[attenuated vaccine|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, |
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'''Ty21a''' is a live [[attenuated]] bacterial vaccine that protects against [[typhoid]].<ref name="pmid17582564">{{cite journal |author=Levine MM, Ferreccio C, Black RE, Lagos R, San Martin O, Blackwelder WC |title=Ty21a live oral typhoid vaccine and prevention of paratyphoid fever caused by Salmonella enterica Serovar Paratyphi B |journal=Clin. Infect. Dis. |volume=45 Suppl 1 |issue= |pages=S24–8 |year=2007 |month=July |pmid=17582564 |doi=10.1086/518141?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dncbi.nlm.nih.gov}}</ref> It is one of two typhoid vaccines currently recommended by the [[World Health Organization]].<ref name="WHO2007">{{cite journal|author=World Health Organization|year=2008|journal=Weekly Epidemiological Record|volume=83|issue=6|pages=49–60|title=Typhoid vaccines: WHO position paper|url=http://www.who.int/wer|pmid=18260212}}</ref> The vaccine offers between 33 and 78% protection. The vaccine is most commonly used to protect travellers to endemic countries, but there is no reason why the vaccine could not be used in large scale public prevention programmes.<ref name="WHO2007"/> |
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including the genes responsible for the production of Vi, have been [[deletion (genetics)|deleted]] so as to render it harmless but nevertheless [[Immunogenicity|immunogenic]]. It is one of the three [[typhoid vaccine]]s currently recommended by the [[World Health Organization]] (the other two being the Typhoid Conjugate Vaccine (TCV) and [[Vi capsular polysaccharide vaccine]]).<ref>{{Cite web |url= https://www.who.int/immunization/policy/position_papers/PP_typhoid_2018_summary.pdf |title=WHO position paper on typhoid Vaccines, March 2018|date=March 2018|website=World Health Organization|access-date=2019-05-05}}</ref> |
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The vaccine is given by mouth. |
The vaccine is given by mouth. The vaccine is presented either as [[Enteric coating|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.<ref name="WHO2007">{{cite journal | vauthors = ((World Health Organization)) | title = Typhoid vaccines: WHO position paper | journal = Relevé Épidémiologique Hebdomadaire | volume = 83 | issue = 6 | pages = 49–59 | date = February 2008 | pmid = 18260212 | url = https://www.who.int/wer/2008/wer8306.pdf }}</ref> |
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== Medical uses == |
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The vaccine offers a statistically significant protection for the first seven years.<ref name=":0">{{cite journal | vauthors = Milligan R, Paul M, Richardson M, Neuberger A | title = Vaccines for preventing typhoid fever | journal = The Cochrane Database of Systematic Reviews | volume = 2018 | issue = 5 | pages = CD001261 | date = May 2018 | pmid = 29851031 | pmc = 6494485 | doi = 10.1002/14651858.CD001261.pub4 }}</ref> 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.<ref name="WHO2007"/> |
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The [[Vi capsular polysaccharide vaccine|Vi polysaccharide vaccine]] is also effective at preventing typhoid fever.<ref name=":0" /> |
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==Dosing== |
==Dosing== |
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The recommended dose varies according to country and preparation. At least three doses are required for protection.<ref name=":1">{{Cite web|url=https://www.who.int/vaccine_safety/initiative/tools/Typhoid_vaccine_rates_information_sheet.pdf|title=World Health Organization Information sheet: Observed rate of vaccine reactions- Typhoid Vaccine|date=April 2014|website=WHO}}</ref> |
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The recommended dose varies according to country. |
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In the |
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|date=September 2022}} |
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In |
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.<ref name="GreenBook">{{cite book | vauthors = Salisbury D, Ramsay M, Noakes K | publisher = Department of Health | title = Immunisation against infectious disease | chapter = "Chapter 33: Typhoid" | chapter-url = http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_125348.pdf | page = 418 | isbn = 0-11-322528-8 | date = 2006-12-11 }}</ref> |
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== |
== Side effects == |
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Side effects of this vaccine are mild and rare.<ref name=":0" /><ref name=":1" /> |
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== Trade names == |
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* Vivotif (manufactured by [[Emergent BioSolutions]])<ref>{{cite web |title=Our Products |url=https://www.emergentbiosolutions.com/products-services/our-products/ |website=Emergent BioSolutions |access-date=20 February 2023}}</ref> |
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== Research == |
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Ty21a may also provide some degree of protection against [[paratyphoid fever]] A and B.<ref name=Levine2007>{{cite journal | vauthors = Levine MM, Ferreccio C, Black RE, Lagos R, San Martin O, Blackwelder WC | title = Ty21a live oral typhoid vaccine and prevention of paratyphoid fever caused by Salmonella enterica Serovar Paratyphi B | journal = Clinical Infectious Diseases | volume = 45 | pages = S24–S28 | date = July 2007 | issue = Suppl 1 | pmid = 17582564 | doi = 10.1086/518141 | doi-access = free }}</ref> This cross-protection by a typhoid vaccine is most likely due to [[O antigen]]s shared between different ''S. enterica'' serotypes.<ref name=Whitaker2009>{{cite journal | vauthors = Whitaker JA, Franco-Paredes C, del Rio C, Edupuganti S | title = Rethinking typhoid fever vaccines: implications for travelers and people living in highly endemic areas | journal = Journal of Travel Medicine | volume = 16 | issue = 1 | pages = 46–52 | year = 2009 | pmid = 19192128 | doi = 10.1111/j.1708-8305.2008.00273.x | doi-access = free }}</ref> |
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A newer [[Vi capsular polysaccharide vaccine|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.<ref name=":0" /> |
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== References == |
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{{reflist}} |
{{reflist}} |
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== External links == |
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* [http://www.paxvax.com/typhoid-vivotif Manufacturer's Product Page] {{Webarchive|url=https://web.archive.org/web/20170612003031/http://www.paxvax.com/typhoid-vivotif |date=2017-06-12 }} |
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{{Vaccines}} |
{{Vaccines}} |
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[[Category:Vaccines]] |
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[[Category:Live vaccines]] |
[[Category:Live vaccines]] |
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[[Category:Enterobacteria]] |
[[Category:Enterobacteria]] |
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[[Category:Typhoid fever]] |
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{{Vaccine-stub}} |
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