Cochrane · systematic review · CD001261

Vaccines for preventing typhoid fever

Milligan, R, Paul, M, Richardson, M, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library

Infectious Diseases2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
19
No studies
1
Included studies
NR
No studies 1 · 4.8%Ungraded 1 · 4.8%Very low 1 · 4.8%Low 4 · 19%Moderate 13 · 61.9%High 1 · 4.8%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 2 versions

Ty21a vaccine (three doses) versus control for preventing typhoid fever

Population: adults and children aged 5 years of age and older
4 questions
OutcomeEffectEvidenceStatus / GRADE
Cases of typhoid fever, Year 1
Ty21a vaccine (three doses) vs control
RR 0.55 [0.35, 0.86]3 studies · 76296 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Cases of typhoid fever, Year 2
Ty21a vaccine (three doses) vs control
RR 0.41 [0.29, 0.57]3 studies · 76296 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Cases of typhoid fever, Year 3
Ty21a vaccine (three doses) vs control
RR 0.44 [0.25, 0.76]3 studies · 76296 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Cumulative cases of typhoid fever at 2.5 to 3 years
Ty21a vaccine (three doses) vs control
RR 0.5 [0.39, 0.65]4 studies · 235239 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency, indirectness

Vi polysaccharide vaccine (1 dose) versus control for preventing typhoid fever

Population: adults and children of 2 years of age and older
7 questions
OutcomeEffectEvidenceStatus / GRADE
Incidence of typhoid fever – year 1 Blood culture
Vi polysaccharide vaccine (1 dose) vs control
RR 0.31 [0.26, 0.37]3 studies · 99797 participantsHigh
Incidence of typhoid fever – year 2
Vi polysaccharide vaccine (1 dose) vs control
RR 0.41 [0.31, 0.55]4 studies · 194969 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Incidence of typhoid fever –year 3
Vi polysaccharide vaccine (1 dose) vs control
RR 0.5 [0.32, 0.78]1 study · 11384 participantsLow
Downgraded: imprecision, inconsistency, indirectness
Cumulative cases of typhoid fever at 2.5 to 3 years
Vi polysaccharide vaccine (1 dose) vs control
RR 0.45 [0.3, 0.7]1 study · 11384 participantsLow
Downgraded: imprecision, inconsistency, indirectness
Serious adverse events
Vi polysaccharide vaccine (1 dose) vs control
no estimate extractedNRNo studies
Fever
Vi polysaccharide vaccine (1 dose) vs control
RR 0.98 [0.84, 1.13]3 studies · 132261 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Erythema
Vi polysaccharide vaccine (1 dose) vs control
RR 1.15 [0.33, 4.03]3 studies · 132261 participantsLow
Downgraded: risk of bias, imprecision, inconsistency, indirectness

Vi‐rEPA vaccine (2 doses) versus control for preventing typhoid fever

Population: adults and children of 2 years of age and older
9 questions
OutcomeEffectEvidenceStatus / GRADE
Incidence of typhoid fever – year 1
Vi‐rEPA vaccine (2 doses) vs control
RR 0.06 [0.01, 0.25]1 study · 12008 participantsModerate
Downgraded: risk of bias, imprecision, indirectness
Incidence of typhoid fever – year 2
Vi‐rEPA vaccine (2 doses) vs control
RR 0.13 [0.04, 0.44]1 study · 12008 participantsModerate
Downgraded: imprecision, indirectness
Cumulative cases of typhoid fever at 2 years
Vi‐rEPA vaccine (2 doses) vs control
RR 0.09 [0.04, 0.22]1 study · 12008 participantsModerate
Downgraded: imprecision, indirectness
Cumulative cases of typhoid fever at 3.8 years
Vi‐rEPA vaccine (2 doses) vs control
RR 0.11 [0.05, 0.23]1 study · 12008 participantsModerate
Downgraded: imprecision, indirectness
Serious adverse events
Vi‐rEPA vaccine (2 doses) vs control
no estimate extracted1 study · 12008 participantsUngraded
Fever after Vi‐rEPA (dose1)
Vi‐rEPA vaccine (2 doses) vs control
RR 2.54 [1.69, 3.62]1 study · 12008 participantsModerate
Downgraded: imprecision, indirectness
Fever after Vi‐rEPA (dose2)
Vi‐rEPA vaccine (2 doses) vs control
RR 4.39 [2.85, 6.77]1 study · 11091 participantsModerate
Downgraded: imprecision, indirectness
Erythema after Vi‐rEPA (dose 2)
Vi‐rEPA vaccine (2 doses) vs control
RR 2.01 [0.19, 22.21]1 study · 11091 participantsLow
Downgraded: imprecision, indirectness
Swelling at injection site after Vi‐rEPA (dose 2)
Vi‐rEPA vaccine (2 doses) vs control
RR 20.15 [2.71, 150.08]1 study · 11091 participantsModerate
Downgraded: imprecision, indirectness

Vi‐TT conjugate vaccine (PedaTyph) (2 doses) versus control for preventing typhoid fever

Population: children aged 6 months to 12 years
1 question
OutcomeEffectEvidenceStatus / GRADE
Incidence of typhoid fever – year 1
Vi‐TT conjugate vaccine (PedaTyph) (2 doses) vs control
RR 0.06 [0, 1.01]1 study · 1625 participantsVery low
Downgraded: risk of bias, imprecision, indirectness