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
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
Current version onlyTy21a vaccine (three doses) versus control for preventing typhoid fever
Population: adults and children aged 5 years of age and older
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cases of typhoid fever, Year 1 Ty21a vaccine (three doses) vs control | RR 0.55 [0.35, 0.86] | 3 studies · 76296 participants | Moderate 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 participants | Moderate 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 participants | Moderate 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 participants | Moderate 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
| Outcome | Effect | Evidence | Status / 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 participants | High |
Incidence of typhoid fever – year 2 Vi polysaccharide vaccine (1 dose) vs control | RR 0.41 [0.31, 0.55] | 4 studies · 194969 participants | Moderate 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 participants | Low 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 participants | Low Downgraded: imprecision, inconsistency, indirectness |
Serious adverse events Vi polysaccharide vaccine (1 dose) vs control | no estimate extracted | NR | No studies |
Fever Vi polysaccharide vaccine (1 dose) vs control | RR 0.98 [0.84, 1.13] | 3 studies · 132261 participants | Moderate 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 participants | Low 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of typhoid fever – year 1 Vi‐rEPA vaccine (2 doses) vs control | RR 0.06 [0.01, 0.25] | 1 study · 12008 participants | Moderate 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 participants | Moderate 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 participants | Moderate 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 participants | Moderate Downgraded: imprecision, indirectness |
Serious adverse events Vi‐rEPA vaccine (2 doses) vs control | no estimate extracted | 1 study · 12008 participants | Ungraded |
Fever after Vi‐rEPA (dose1) Vi‐rEPA vaccine (2 doses) vs control | RR 2.54 [1.69, 3.62] | 1 study · 12008 participants | Moderate 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 participants | Moderate 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 participants | Low 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 participants | Moderate Downgraded: imprecision, indirectness |
Vi‐TT conjugate vaccine (PedaTyph) (2 doses) versus control for preventing typhoid fever
Population: children aged 6 months to 12 years
| Outcome | Effect | Evidence | Status / 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 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Ty21a vaccine (three doses) compared with control; efficacy for preventing typhoid fever
Population: adults and children aged 5 years of age and older
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of typhoid fever, Year 1 Ty21a vaccine (three doses) vs control; efficacy | RR 0.65 [0.46, 0.92] | 1 study · 20543 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Incidence of typhoid fever, Year 2 Ty21a vaccine (three doses) vs control; efficacy | RR 0.42 [0.29, 0.6] | 1 study · 20543 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Serious adverse events Ty21a vaccine (three doses) vs control; efficacy | no estimate extracted | 3 studies · 2620 participants | Ungraded |
Fever Ty21a vaccine (three doses) vs control; efficacy | RR 1.53 [0.86, 2.72] | 2 studies · 2066 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Rash Ty21a vaccine (three doses) vs control; efficacy | RR 1.89 [0.56, 6.43] | 2 studies · 1190 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Vomiting Ty21a vaccine (three doses) vs control; efficacy | RR 0.61 [0.3, 1.24] | 1 study · 2066 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Any mild adverse event Ty21a vaccine (three doses) vs control; efficacy | RR 1.67 [1.03, 2.72] | 2 studies · 1360 participants | Moderate Downgraded: risk of bias, imprecision, indirectness |
Vi polysaccharide vaccine (one dose) compared with control; efficacy for preventing typhoid fever
Population: adults and children of 2 years of age and older
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of typhoid fever—Year 1 Blood culture Vi polysaccharide vaccine (one dose) vs control; efficacy | RR 0.31 [0.26, 0.37] | 3 studies · 99797 participants | High |
Incidence of typhoid fever—Year 2 Vi polysaccharide vaccine (one dose) vs control; efficacy | RR 0.41 [0.31, 0.55] | 4 studies · 194969 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Serious adverse events Vi polysaccharide vaccine (one dose) vs control; efficacy | no estimate extracted | 4 studies · 133240 participants | Ungraded |
Fever Vi polysaccharide vaccine (one dose) vs control; efficacy | RR 0.93 [0.57, 1.53] | 4 studies · 133038 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Erythema Vi polysaccharide vaccine (one dose) vs control; efficacy | RR 1.15 [0.33, 4.03] | 3 studies · 132261 participants | Low Downgraded: risk of bias, imprecision |
Vi‐rEPA vaccine (two doses) compared with control; efficacy for preventing typhoid fever
Population: adults and children of 2 years of age and older
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of typhoid fever—Year 1 Vi‐rEPA vaccine (two doses) vs control; efficacy | RR 0.06 [0.01, 0.25] | 1 study · 12008 participants | Moderate Downgraded: risk of bias, indirectness |
Incidence of typhoid fever—Year 2 Vi‐rEPA vaccine (two doses) vs control; efficacy | RR 0.13 [0.04, 0.44] | 1 study · 12008 participants | Moderate Downgraded: indirectness |
Serious adverse events Vi‐rEPA vaccine (two doses) vs control; efficacy | no estimate extracted | 2 studies · 12209 participants | Ungraded |
Fever after Vi‐rEPA (dose1) Vi‐rEPA vaccine (two doses) vs control; efficacy | RR 1.55 [0.57, 4.23] | 2 studies · 12209 participants | Low Downgraded: imprecision, inconsistency |
Erythema after Vi‐rEPA (dose 1) Vi‐rEPA vaccine (two doses) vs control; efficacy | RR 3.03 [0.32, 28.64] | 2 studies · 12209 participants | Moderate Downgraded: imprecision |
Swelling at injection site after Vi‐rEPA (dose 1) Vi‐rEPA vaccine (two doses) vs control; efficacy | RR 1.01 [0.15, 7.03] | 2 studies · 12209 participants | Moderate Downgraded: imprecision |