USE OF TYPHOID VACCINE IN PREGNANCY

Typhoid fever is a potentially severe systemic febrile illness endemic in developing countries. The disease is linked to poor sanitation, and faecal contamination of food and water are the main sources of infection. Travel to endemic regions constitutes a major risk for contracting the disease. Pregnant women may be at increased risk of contracting typhoid fever and of its associated complications such as gastrointestinal bleeding, hepatic dysfunction and intestinal perforation, compared to non-pregnant patients. Typhoid fever may also increase the risk of miscarriage.

Two types of typhoid vaccine are available in the United Kingdom: an inactivated Vi polysaccharide vaccine and a live attenuated oral typhoid vaccine. Very little information is available regarding pregnancy outcomes following typhoid vaccination in human pregnancy.

Pregnant women are advised to avoid travel to areas where typhoid fever is endemic wherever possible. When travel during pregnancy cannot be avoided, the United Kingdom Department of Health recommends that maternal typhoid vaccination should be considered if there is a high risk of infection. The inactivated Vi polysaccharide vaccine may be preferable in pregnancy due to the theoretical risk of fetal infection from live vaccines. Exposure to typhoid vaccine at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy or any additional fetal monitoring. However, other risk factors may be present in individual cases which may independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors when performing case-specific risk assessments.