Efficacy of typhoid conjugate vaccine: final analysis of a 4-year, phase 3, randomised controlled trial in Malawian children.

Further, immunogenicity data from both the Nepal and this trial showed numerically more rapid decline in vaccine-induced antibody titres in younger children compared with older age groups but this did not reach statistical significance. 18 , 25 A mathematical model of the transmission dynamics of S Typhi predicted that a waning of vaccine-induced immunity could lead to a rebound in typhoid incidence 5–15 years after vaccine introduction, emphasising the need for longer term efficacy data. 27 Whether additional benefit could be gained with a second dose of vaccine is unknown.

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