title: Comparison of safety and immunogenicity of a Vi polysaccharide typhoid vaccine with a whole-cell killed vaccine in Malaysian Air Force recruits.
abstract: OBJECTIVE
  To carry out a comparative study of the safety and immunogenicity of Vi polysaccharide vaccine against whole-cell killed (WCK) typhoid vaccine.
  
  
  METHODS
  The study was carried out on young adult recruits (aged 18-25 years) of the Malaysian Air Force. A total of 125 subjects received the Vi polysaccharide vaccine and 114 received the WCK vaccine.
  
  
  RESULTS
  The Vi vaccine was significantly less reactogenic than the WCK vaccine with regard to systemic and local reactions. Following administration of the Vi vaccine, seroconversion rates (defined as the percentage of subjects with a 4-fold rise of baseline antibody level) of 75.5% and 67% were observed at 2 weeks and 6 weeks, respectively, after immunization, compared with 25% and 31.3% among recipients of the WCK vaccine. Of the 110 Vi vaccinees with serological data, 21 (19%) had high, seroprotective, pre-immunization levels of anti-Vi antibodies (> or = 1 microgram/ml). The majority of subjects in this group came from a region in Malaysia which is known to have high typhoid endemicity. Interestingly, these antibody levels were boosted considerably following administration of vaccine at a level that was 5-fold higher than in subjects with low pre-immunization levels. In contrast, the seroconversion rates in those receiving the Vi vaccine were higher in subjects with low pre-immunization levels of anti-Vi antibodies (76-84%), compared to those with protective levels of > or = 1 microgram/ml prior to immunization (48-57%).
  
  
  CONCLUSIONS
  The study reaffirms the safety and efficacy of the Vi polysaccharide vaccine and identifies a hitherto unrecognized advantage in its use, i.e. it is a potent immunogen that boosted considerably the protective antibody levels among a significant number of immunologically sensitized individuals living in typhoid-endemic regions.
authors.affiliation: Institute of Postgraduate Studies and Research, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: V
authors.initials: V
authors.lastname: Panchanathan
authors.forename: S
authors.initials: S
authors.lastname: Kumar
authors.forename: W
authors.initials: W
authors.lastname: Yeap
authors.forename: S
authors.initials: S
authors.lastname: Devi
authors.forename: R
authors.initials: R
authors.lastname: Ismail
authors.forename: S
authors.initials: S
authors.lastname: Sarijan
authors.forename: S M
authors.initials: SM
authors.lastname: Sam
authors.forename: Z
authors.initials: Z
authors.lastname: Jusoh
authors.forename: S
authors.initials: S
authors.lastname: Nordin
authors.forename: D
authors.initials: D
authors.lastname: Leboulleux
authors.forename: T
authors.initials: T
authors.lastname: Pang
mesh_terms: D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D006801:Humans; D008296:Malaysia; D008889:Military Personnel; D011135:Polysaccharides, Bacterial / Q000009:adverse effects / Q000276:immunology*; D012449:Safety; D016896:Treatment Outcome; D014436:Typhoid-Paratyphoid Vaccines / Q000009:adverse effects / Q000276:immunology*
chemical_list: D000907:Antibodies, Bacterial; D011135:Polysaccharides, Bacterial; D014436:Typhoid-Paratyphoid Vaccines; C057664:Vi polysaccharide vaccine, typhoid