Combined enteric and cholera vaccination by the intradermal route

Abstract

The protection afforded by a combined enteric and cholera vaccine administered by the intradermal route, and demonstrated by active and passive mouse protection tests and agglutination titres, is excellent and equal to that given individually by the component TAB and cholera vaccines.In order to reduce the number of injections required and the unpleasant reactions provoked it is suggested that combined enteric and cholera vaccine administered by the intradermal route is of value, where appropriate, for the vaccination of travellers, and for the rapid protection of non-immune persons in the event of natural disasters or mobilization.

Immunization of man with typhoid and cholera vaccine. Agglutinating antibodies after intracutaneous and subcutaneous injection

“…The intracutaneous method also proved satisfactory for vaccination with cholera vaccine (Singer, Weis & Hoa, 1948;Noble, 1964) and a combination of cholera and typhoid vaccine (Noble & Fielding, 1965). After preliminary investigations (Barr, Sayers & Stamm, 1959), the intracutaneous vaccination method was adopted by the British Army for routine immunization with a combined vaccine containing enteric and tetanus antigens (Noble, 1963).…”

Combination vaccines against diarrheal diseases

“…Human volunteers were vaccinated ID with 2 0.1 ml volumes of TAB/Ch spaced 21 days apart. 48 The data indicated 2–8 fold higher agglutinin responses to the O-antigens of S. typhi and V. cholera and was validated by animal studies in mice. The conclusions drawn from this study was that a combined enteric and cholera vaccine could be given ID and was preferable over the administration of the 2 components separately.…”

“…50,51 TAB was also combined with heat-killed and phenol-preserved V. cholera strain Ogawa (TAB/Ch) and evaluated singly or combined and administered by the ID route. 48 The combined TAB/Ch vaccine contained 5 × 10 9 CFU of enteric organisms and 8 × 10 9 CFU of cholera organisms per ml suspended in 0.5% phenol saline. The combined vaccine in this case was obtained by adding equal quantities of double-strength TAB and cholera vaccines.…”

“…The conclusions drawn from this study was that a combined enteric and cholera vaccine could be given ID and was preferable over the administration of the 2 components separately. 48 Thus ID vaccination with a combined vaccine became a routine procedure in the British Services. This vaccine however, did not meet with the same success in the US because the immunogenicity patterns to the 3 different pathogens were not duplicated.…”