A randomized, open-label study of the immunogenicity and reactogenicity of three lots of a combined typhoid fever/hepatitis A vaccine in healthy adults.
BACKGROUND
Travelers are often advised to receive both the typhoid fever and hepatitis A virus (HAV) vaccines, particularly when going to areas where the 2 diseases are endemic. Thus, combined administration of these vaccines could make immunization more acceptable by reducing the number of injections needed.


OBJECTIVE
This study compared the safety profiles and immunogenicity of 3 batches of a combined typhoid fever/HAV vaccine administered using a dual-chamber bypass syringe.


METHODS
This randomized, open-label study was conducted at 2 university-based travel clinics in Germany and Austria. Subjects received a single IM injection from 1 of 3 batches of the combined vaccine. Blood samples were drawn immediately before and 28 days after vaccination to evaluate the response to the 2 antigens by assessing geometric mean titers (GMTs) and rates of seroconversion and seroprotection. Subjects recorded all adverse events (AEs) occurring during the study period in a diary.


RESULTS
Six hundred ten healthy adults were enrolled in the study. Twenty-eight days after vaccination, 90.6% of the study population had protective typhoid Vi antibody titers (> or = 1 microg/mL) and 100% had protective HAV antibody titers (> or = 20 mIU/mL). Seroconversion rates and GMTs were not significantly different between the 3 batches. There were no differences with regard to local or systemic AEs between the 3 batches of vaccine. There were no immediate adverse reactions (within 30 minutes of vaccination) and no serious AEs related to vaccination. Of 609 evaluable subjects (1 was lost to follow-up after the first visit), 555 (91.1%) experienced > or = 1 local reaction within the first 7 days after vaccination, mainly pain at the injection site (550 [90.3%]), but only 26 (4.3%) described this pain as severe. Vaccine-related headache and mild to moderate asthenia were each reported by 54 subjects (8.9%). Symptoms resolved spontaneously in all cases.


CONCLUSIONS
The 3 batches of the combined typhoid fever/HAV vaccine administered by dual-chamber bypass syringe were equally well tolerated and effective in healthy adults, and did not differ significantly in terms of GMTs or seroconversion rates.
Loebermann
Micha
M
Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, University of Rostock, D-18057 Rostock, Germany. micha.loebermann@medizin.uni-rostock.de
Kollaritsch
Herwig
H
Ziegler
Tom
T
Rendi-Wagner
Pamela
P
Chambonneau
Laurent
L
Dumas
Rafaele
R
Lafrenz
Michael
M
D000328:Adult; D000914:Antibodies, Viral / Q000302:isolation & purification; D001317:Austria; D004334:Drug Administration Schedule; D005260:Female; D005858:Germany; D006506:Hepatitis A / Q000276:immunology / Q000517:prevention & control*; D022362:Hepatitis A Vaccines / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D014435:Typhoid Fever / Q000276:immunology / Q000517:prevention & control*; D014436:Typhoid-Paratyphoid Vaccines / Q000008:administration & dosage*; D017778:Vaccines, Combined / Q000008:administration & dosage* / Q000009:adverse effects
D000914:Antibodies, Viral; D022362:Hepatitis A Vaccines; D014436:Typhoid-Paratyphoid Vaccines; D017778:Vaccines, Combined