Experience with Salmonella typhi Vi capsular polysaccharide vaccine

Typhoid fever remains an important health threat in many parts of the world, with an estimated 16 million cases and 600 000 deaths occurring each year. The emergence of Salmonella typhi strains multiply resistant to antibiotics has complicated the treatment of this disease. Field experience of 8 years shows that a vaccine composed of purified Vi capsular polysaccharide of Salmonella typhi, given as a single intramuscular or deep subcutaneous injection, has consistent immunogenicity and efficacy. Side effects, based on reports since 1989, are infrequent and mild. Furthermore, the Vi vaccine may be administered simultaneously with other common "travel" vaccines, at two different sites of injection, without affecting immunogenicity and tolerability. This review presents an update of the development and clinical experience with the Salmonella typhi Vi polysaccharide vaccine (Typhim Vi; Pasteur Merieux Connaught, France).