In view of the limited duration of productivity, typhoid vaccination has not been included as mandatory, inspite of the wide prevalence of typhoid fever in India. The heat killed, phenol preserved whole cell Salmonella typhii vaccine contains not only S. typhii also S. paratyphi and it is protective through induction of somatic O antigens and flagellar H antigens.
A new oral, attenuated live vaccine derived from Ty-21A has been used widely now with some efficacy and less adverse reactions. It is delivered in enteric-coated capsule form, which needs to be swallowed as a whole, which limits its usefulness in children less than 6 years of age. The only contraindication for the oral vaccine is HIV.