Types of typhoid vaccines for children
Typhoid fever, caused by Salmonella typhi, is a major health concern in India, especially for children. It is one of the most common causes of community-acquired infections that spread mainly through contaminated food and water. Children under 5 years of age are more likely to experience severe symptoms of typhoid, including diarrhoea, vomiting, dehydration and in some cases, neurological issues like seizures or delirium. School-aged children may also develop neurological complications and respiratory issues.[1]
Thankfully, vaccines help prevent typhoid and protect children from this dangerous disease.
What is typhoid and how does it spread?[1,3]
Typhoid fever is caused by the bacterium Salmonella typhi. Typhoid is an important public health concern in India, especially because of the emergence of certain drug-resistant strains of the bacteria, which make treatment more difficult.
Typhoid spreads mainly through the faecal-oral route, meaning it is transmitted when someone consumes food or water contaminated with the stool of an infected person. Since children are often less consistent with hygiene practices, they are particularly vulnerable to typhoid. While unsafe drinking water, contaminated food and poor sanitation are the most common sources of typhoid fever, children may also come into contact with chronic carriers of the bacteria who unknowingly spread the disease. With resistant strains continuing to emerge, vaccination and preventive measures can protect families from typhoid.
Why is typhoid vaccination important for children?
India has one of the highest burdens of typhoid fever in the world.[4,5] The World Health Organization (WHO) recommends routine typhoid vaccination for children aged between 6 months and 15 years, especially in countries with outbreaks of drug-resistant typhoid, such as India.[2] Typhoid fever, especially when untreated, can have a fatality rate as high as 10–20%.[3] Vaccinating children helps reduce the spread of this dangerous disease and prevent severe complications, including death. The WHO’s focus on vaccination in endemic regions, particularly where multidrug-resistant strains are prevalent, can help control the disease and safeguard public health.[2]
Types of typhoid vaccines available for children
1. Oral Typhoid Vaccine (Live Attenuated Vaccine)
The oral typhoid vaccine (live attenuated) is effective in preventing typhoid but is not available in India. It is mainly used in other countries, especially for travellers.[2,3]
2. Vi Polysaccharide Vaccine
The Vi Polysaccharide typhoid vaccine helps prevent typhoid, but it cannot be administered to children under 2 years of age and does not provide long-lasting protection. A booster dose is usually advised every 3 years to maintain effectiveness. The vaccine has a 55–61% efficacy.[3]
3. Typhoid Conjugate Vaccine (TCV)
The Typhoid Conjugate Vaccine (TCV) offers better protection than older vaccines. It works well in younger children and can be given to children at 6 months of age. It provides longer-lasting immunity. A single dose of TCV is recommended by the WHO for children aged between 6 and 23 months in areas where typhoid is common. TCV also helps with herd immunity and strengthens the body’s long-term defence.[2,3]
Recommended typhoid vaccination schedule for children
The Typhoid Conjugate Vaccine (TCV) is recommended as a single dose starting at 6 months of age. The typhoid vaccine schedule can be given along with the measles vaccine from 9 months onwards. For children who have had the Vi Polysaccharide vaccine, TCV can be administered at least 4 weeks later.
The Vi Polysaccharide Vaccine is recommended for children aged 2 years and above, with a booster dose as per the doctor’s recommendation. However, TCV is preferred for its longer-lasting protection, especially for younger children. Health experts strongly recommend the inclusion of typhoid vaccines in India’s routine immunisation programme.[3]
How effective are typhoid vaccines?
The Typhoid Conjugate Vaccine (TCV) has shown high efficacy in protecting against typhoid fever. In clinical trials, TCV showed an efficacy rate of 87.1% in preventing typhoid fever among adults.* In comparison, the Vi Polysaccharide (Vi-PS) vaccine offers an efficacy rate of 55-61%.[3]
*This data is taken from studies conducted on Typbar-TCV. Data is not available for other TCV vaccines.
Are typhoid vaccines safe for children?
Both the Typhoid Conjugate Vaccine (TCV) and Vi Polysaccharide (Vi-PS) vaccines are safe for children. The advantage of the TCV is that it is a typhoid vaccine for infants as young as 6 months of age. It is also compatible with other vaccines, such as MMR. The WHO recommends TCV as part of routine immunisation in high-risk regions. As per the IAP Advisory Committee on Vaccines & Immunization Practices, a single dose of TCV is recommended for children from 6 months onward. TCV can be administered with the measles vaccine at 9 months, and if a child has already received the Vi-PS vaccine, TCV should be given after 4 weeks.[3]
Additional ways to protect children from typhoid
Vaccination should be combined with proper WASH (water, sanitation and hygiene) practices for maximum protection. Teaching children the importance of washing hands with soap and water, safe drinking water and clean food habits plays a significant role in preventing not just typhoid but also other diseases. Good sanitation practices, like safely disposing of waste, washing fruits and vegetables properly, handwashing with soap before preparing food or eating and after using the washroom, are essential for reducing the spread of typhoid. Focusing on WASH education alongside vaccination creates a healthier environment and reduces overall disease risk, benefiting both individuals and communities.[1]
Conclusion
Typhoid remains a significant health challenge in India, especially for children. With the right vaccination and hygiene practices, it can be prevented. By ensuring that children receive the recommended vaccines and teaching them proper hygiene, we can reduce the spread of typhoid and other preventable diseases. While there is no fixed typhoid vaccine age for kids in India, both the WHO and the IAP recommend vaccination as a method of prevention.
Let’s prioritise typhoid vaccination and create a safer, healthier environment for our children. Consult your doctor today to learn more about vaccination.
FAQs
At what age can children receive the typhoid vaccine?
There are two types of typhoid vaccines commonly used for children in India. Children can receive the Typhoid Conjugate Vaccine (TCV) starting at 6 months of age. The Vi Polysaccharide Vaccine (ViPS) is recommended for children aged 2 years and above.
How long does typhoid vaccine protection last?
Consult your doctor to learn more about how long you can stay protected with vaccination.
Is typhoid vaccination mandatory for children?
Typhoid vaccination is strongly recommended for children, especially in endemic areas like India, to protect them from typhoid fever.
Can vaccinated children still get typhoid?
While typhoid vaccines’ protection is strong, no vaccine is 100% effective. Vaccinated children may still be at risk, though they are much less likely to develop severe disease.
Do children need booster doses for typhoid vaccination?
Booster doses are required for the Vi Polysaccharide Vaccine every 2 to 3 years. However, the Typhoid Conjugate Vaccine (TCV) does not require boosters as frequently, and a single dose provides long-term protection.
Resources
- https://www.ncbi.nlm.nih.gov/books/NBK557513/
- https://www.ncbi.nlm.nih.gov/books/NBK470571/
- Purple Book: IAP Guidebook on Immunization 2022 By Advisory Committee on Vaccines and Immunization Practices (ACVIP)
- https://www.nejm.org/doi/pdf/10.1056/NEJMoa2209449
- https://pubmed.ncbi.nlm.nih.gov/35238365/
Disclaimer: A public awareness initiative by Bharat Biotech International Limited. This information is for general awareness only and does not constitute medical advice. The doctors, medical facilities and graphics shown are for illustrative purposes only. For any medical advice or any question or concern you may have regarding your condition, consult your doctor.