Typhoid conjugate vaccine (TCV) vs Vi polysaccharide vaccine (ViCPS): Which one to take?
Typhoid fever remains a serious health concern in India, with lakhs of cases being reported every year.[1,2] Two vaccines are widely used to prevent it: the typhoid conjugate vaccine (TCV) and the Vi polysaccharide vaccine (ViCPS). While both protect against typhoid, they work differently and are recommended for different age groups.[1] This blog compares typhoid vaccines, helping you understand the key differences, so you can make an informed choice on which typhoid vaccine is better.
What is typhoid, and why does vaccination matter?
Typhoid fever is caused by the bacterium Salmonella typhi, and it spreads mainly through contaminated food and water, particularly in areas where sanitation is poor.[2,3] It starts with symptoms like prolonged fever, headache, stomach discomfort, and loss of appetite. In serious cases, it can lead to life-threatening complications.[3]
The numbers tell a sobering story. Globally, an estimated 9 to 21 million cases and up to 1,61,000 deaths from typhoid occur every year.[2,3] India is one of the worst-affected countries in the world. Children bear the heaviest burden, especially those between the ages of 5 and 15 years, and infants under 1 year.[2]
What makes this even more urgent is that typhoid bacteria are increasingly becoming resistant to common antibiotics, meaning treatment is getting harder.[2] Vaccination is one of the most reliable ways to stay protected.
What is the typhoid conjugate vaccine (TCV)?
TCV is an injectable vaccine that works by combining the typhoid antigen with a carrier protein. This combination prompts the immune system to build a stronger response, as well as an immune memory, which means your body stays prepared to fight the infection even years after vaccination.[1,2]
A single dose of TCV is all that is needed, and it is suitable for younger children from 6 months of age.[1,3] It can be safely administered alongside other routine vaccines in childhood such as measles, so it fits easily into the standard immunisation schedule.[1]
The World Health Organization (WHO) has listed TCV as an essential medicine, recognising its role in controlling typhoid globally. Typhoid conjugate vaccine has also been used effectively to stop outbreaks of drug-resistant typhoid.[2] As of 2024, six countries have incorporated TCV into their routine immunisation programmes, and Gavi, the Vaccine Alliance, has been funding its rollout in eligible countries since 2019.[2,3]
What is the Vi polysaccharide vaccine (ViCPS)?
Vi-capsular polysaccharide vaccine (ViPS or ViCPS) is also an injectable vaccine. It works by introducing a purified form of the Vi antigen (a component found on the surface of the typhoid bacteria) which triggers the immune system to produce protective antibodies.[1]
The Vi polysaccharide vaccine has some limitations. It does not build immune memory, so protection fades over time and a booster is needed every 3 years.[1] It also cannot be given to children below 2 years of age, as their immune systems are not mature enough to respond to this type of vaccine.[1]
TCV vs ViCPS: Key differences
Vaccine effectiveness
| TCV | ViCPS | |
|---|---|---|
| Efficacy | 83–87% against confirmed typhoid[1,2,3] | ~61% in year 1; drops to ~55–57% by year 3[1,2] |
| Herd protection | Yes, unvaccinated people in vaccinated communities also show lower infection rates[1] | Limited evidence |
Duration of protection
| TCV | ViCPS | |
|---|---|---|
| How long does it last? | At least 7 years[1] | Significant decline by year 3[1,2] |
| Immune memory | Yes, the body stays primed to fight infection[1] | No, the protection fades without boosters[1] |
Age eligibility
| TCV | ViCPS | |
|---|---|---|
| Minimum age | 6 months[1,3] | 2 years[1] |
| Adults | Suitable and preferred[1,3] | Suitable[1] |
Booster requirement
| TCV | ViCPS | |
|---|---|---|
| Booster dose | No routine booster is currently recommended[1] | Yes, based on doctor’s consultation[1,2] |
Which typhoid vaccine should you choose?
Both vaccines prevent typhoid, but they are not equal in strength, duration, or who they can be given to. Vi polysaccharide vaccine’s duration is around 3 years, and a booster dose is needed after that. TCV is now the preferred choice at all ages, as recommended by both the WHO and India’s Advisory Committee on Vaccines and Immunization Practices (ACVIP).[1,3]
For children
Typhoid conjugate vaccine for children is the clear first choice. It can be given as early as 6 months of age, builds immune memory, and only requires a single dose.[1,3] India’s IAP/ACVIP recommends a single dose of TCV routinely from 6 months onward, and it can be given at the same time as the measles vaccine at 9 months or the MMR vaccine at 15 months.[1]
A single dose of TCV can be given at least 4 weeks after their last ViCPS dose.[1]
For adults
Typhoid conjugate vaccine (TCV) is the preferred option for adults, offering stronger and longer-lasting protection.[1,3] If you live in India, where typhoid is already widespread, getting vaccinated is a straightforward way to protect yourself, regardless of where you live or work. One common misconception is that having had typhoid fever in the past means you are immune. It does not. If you have had typhoid before, you are still recommended to get vaccinated, following the same guidelines as everyone else. Typhoid conjugate vaccine’s benefit is that it is also safe for adults who are immunocompromised, including those living with HIV.[2]
When ViCPS may be used
ViCPS is suitable for children aged 2 years and above, and for adults as well. IAP/ACVIP recommends it as an intramuscular injection, with a booster every 3 years. However, it is best to consult your doctor for guidance. A child who has had a suspected or confirmed typhoid infection can receive ViCPS at least 4 weeks after recovery, provided they have not been vaccinated in the past 3 years.[1]
Are there any side effects?
Both TCV and ViCPS are safe and generally well-tolerated. The most common side effects of typhoid vaccine are mild pain, swelling, or redness at the injection site. These typically resolve on their own within a day or two. A mild fever in the days following vaccination is also possible, and is simply a sign that the immune system is responding.[1,2]
Both vaccines can be safely given to immunocompromised individuals and to pregnant or lactating women when vaccination is warranted.[2]
Conclusion
Both TCV and ViCPS are proven, safe vaccines, providing protection against typhoid fever. However, TCV offers stronger protection, works in younger children from 6 months of age, builds lasting immune memory, and does not require frequent boosters.
Given India’s high burden of typhoid and the growing threat of drug-resistant strains, getting vaccinated is one of the most important steps you can take to protect yourself and your family. Consult your doctor today to learn more about typhoid vaccination, and get the right vaccine for you and your family.
FAQs
Which typhoid vaccine is better, TCV or ViCPS?
TCV is the preferred vaccine at all ages, as recommended by both the WHO and India’s IAP/ACVIP. It offers higher efficacy, longer duration of protection, and can be given to children as young as 6 months.
How long does TCV last compared to ViCPS?
TCV protection has been shown to last up to 7 years after a single dose, and it builds immune memory. ViCPS has booster dose requirements.
Can children take the ViCPS vaccine?
ViCPS can only be given to children aged 2 years and above. For children under 2, TCV is the only suitable option and is strongly recommended.
Do I need a booster after TCV?
No routine booster is currently recommended after a single dose of TCV.
Is TCV safe for adults?
Yes. TCV is a safe typhoid vaccine for adults and is the preferred vaccine across all age groups.
Resources
- IAP Guidebook on Immunization 2022 (Purple Book)
- https://www.ncbi.nlm.nih.gov/books/NBK470571/
- https://www.who.int/teams/immunization-vaccines-and-biologicals/diseases/typhoid
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.