Typhoid Vaccination — SCE Infectious Diseases MCQ

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EasyTravel Medicine & VaccinationTyphoid VaccinationSCE Infectious Diseases

A 40-year-old woman who is HIV positive (CD4 580, VL <50 on ART) plans to travel to India for 4 weeks. She is up to date with routine vaccinations. Which travel vaccine is NOT suitable for her?

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Correct answer: B — Oral typhoid vaccine (Ty21a — live attenuated)

The oral typhoid vaccine (Ty21a/Vivotif) is a live attenuated vaccine and should be avoided in immunocompromised patients including those with HIV (regardless of CD4 count in some guidelines, or if CD4 <200 in others). The injectable Vi polysaccharide typhoid vaccine is inactivated and safe in HIV. All other listed vaccines are non-live and appropriate. BHIVA vaccination guidelines provide specific advice on live vaccine eligibility in HIV based on CD4 count.

Reference: BHIVA 2024 – Vaccination guidelines for adults with HIV; UKHSA 2024 – Green Book Chapter 33: Typhoid