Trial reportJournal of travel medicine2026
Co-administration of oral killed whole-cell recombinant cholera toxin B-subunit vaccine (WC-rCTB) and live Salmonella Typhi Ty21a vaccine: a prospective randomized open-label trial.
Trial report in Journal of travel medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCholera and typhoid fever are often co-endemic, making vaccine co-administration practical. However, due to lack of immunogenicity data, current guidelines advise against co-administration of the oral inactivated whole-cell recombinant cholera toxin B-subunit vaccine (WC-rCTB) and the oral live Salmonella Typhi Ty21a vaccine.
methodsHealthy adults (18-65 years) were randomized 1:1:1 to receive WC-rCTB with Ty21a (group Ch + Ty), WC-rCTB alone (group Ch) or Ty21a alone (group Ty). Peripheral blood mononuclear cells (PBMCs) were isolated on Days 0, 5 and 7 from all, plus on Days 12 and 14 from WC-rCTB recipients, to assess antibody-secreting cells (ASCs) specific to rCTB and to typhoidal O9,12-structures by enzyme-linked immunosorbent spot (ELISPOT) assay. Vibriocidal antibodies were assessed, and anti-rCTB IgA/IgG and anti-S. Typhi lipopolysaccharide (LPS) IgA/IgG/IgM were measured by enzyme-linked immunosorbent assay (ELISA) in Day 0 and 28 ± 3 serum samples. Adverse events (AEs) were recorded during one month.
resultsThe final study population included 63 volunteers, 21 per group. A non-significant trend towards stronger rCTB-specific ASC (IgA + IgG + IgM) peak responses was observed in group Ch + Ty compared to group Ch (geometric mean, GM 94 vs 32 ASC/106 PBMC, P = 0.096). Serum anti-rCTB IgA and IgG fold rises (post-vaccination vs pre-vaccination) were higher in group Ch + Ty than in group Ch (IgA P = 0.039, IgG P = 0.028), whereas vibriocidal fold rises were comparable between the two groups (P = 0.847). ASC (IgA + IgG + IgM) peak responses to typhoidal O9,12-structures were comparable between groups Ch + Ty and Ty (GM 183 vs. 210 ASC/106 PBMC, P = 0.684). Serum anti-S. Typhi LPS IgA, IgG and IgM fold rises were also similar across Ch + Ty and Ty groups (all P-values ≥0.145). AEs were comparable in single and co-administration groups.
conclusionsCo-administration of the oral cholera and typhoid vaccines demonstrated favourable safety and robust immunogenicity for both vaccines, supporting their simultaneous use without spacing precautions.
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