Salmonella Typhi Vaccine (5mcg)

Clinical Pharmacologist's Monograph

⚠️ Prescription Only: This medicine is Schedule H/H1. Do not self-medicate.

1. Clinical Overview

Salmonella Typhi Vaccine (5mcg) is a purified Vi capsular polysaccharide vaccine for active immunization against typhoid fever caused by Salmonella enterica serovar Typhi. It is a subunit vaccine containing the Vi antigen, which is a key virulence factor of the bacterium. It induces a T-cell independent immune response, primarily producing IgG antibodies that prevent bacterial invasion by blocking attachment and complement-mediated killing. It is a critical public health tool in endemic regions like India.

OnsetDurationBioavailability
Protective antibody levels are typically achieved within 7-14 days post-vaccination.Protection lasts for approximately 3 years. Revaccination is recommended every 3 years for continued risk.Not applicable (Parenteral administration).

2. Mechanism of Action

The vaccine contains the purified Vi (virulence) capsular polysaccharide antigen of Salmonella Typhi. Upon intramuscular injection, the antigen is taken up by antigen-presenting cells and presented to B-lymphocytes in a T-cell independent manner. This stimulates the proliferation and differentiation of specific B-cell clones into plasma cells that secrete anti-Vi IgG antibodies. These circulating antibodies bind to the Vi capsule on invading Salmonella Typhi bacteria, facilitating opsonization and complement-mediated bacteriolysis, thereby preventing systemic infection.

3. Indications & Uses

  • Active immunization against typhoid fever caused by Salmonella Typhi in adults and children ≥2 years of age.
  • Prophylaxis for individuals traveling to or residing in typhoid-endemic areas, including many parts of India.

4. Dosage & Administration

Adult Dosage: Single 0.5 mL intramuscular injection containing 5mcg of purified Vi polysaccharide.

Administration: For intramuscular use only, preferably in the deltoid muscle. Do not administer intravenously, intradermally, or subcutaneously. Shake the vial or pre-filled syringe well before use. Use a separate, sterile syringe and needle for each patient. Observe for syncope for 15 minutes post-vaccination.

5. Side Effects

Common side effects may include:

  • Pain, tenderness, redness, or induration at the injection site (up to 40%).
  • Low-grade fever (<38°C).
  • Headache.
  • Malaise, myalgia.

6. Drug Interactions

DrugEffectSeverity
Immunosuppressants (e.g., corticosteroids, chemotherapy, biologics)Diminished antibody response to the vaccine.Major
Anticoagulants (e.g., warfarin)Increased risk of bleeding or hematoma at injection site.Moderate
Other Vaccines (e.g., Yellow Fever, Hepatitis A)No clinically significant interaction. Can be administered simultaneously at different sites.Minor

7. Patient Counselling

  • Do inform the doctor about any allergies, especially to vaccine components or previous vaccines.
  • Do report if you are pregnant, planning pregnancy, or breastfeeding.
  • Do keep a record of your vaccination date and brand.
  • Don't take the vaccine if you have a high fever or severe illness on the day of vaccination.
  • Don't rub the injection site vigorously.

8. Toxicology & Storage

Overdose: Unlikely due to single-dose administration in a pre-filled syringe. Theoretical overdose could exacerbate local and systemic reactions (e.g., severe pain, high fever, pronounced malaise).

Storage: Store between +2°C to +8°C (refrigerator). Do not freeze. Protect from light. Do not use if frozen. Keep the vial/syringe in the outer carton. Use immediately after opening. Do not use after the expiry date. Transport in a cold chain.