What is the recommended vaccination schedule for an adult seeking immunization against varicella (chickenpox), Hepatitis A (infectious hepatitis), and Typhoid (Salmonella Typhi)?

From the Guidelines

For an adult seeking varicella, Hepatitis A, and typhoid vaccines, I recommend starting with the first doses of varicella and Hepatitis A vaccines at the initial visit, as these can be administered simultaneously, according to the advisory committee on immunization practices recommended immunization schedule for adults aged 19 years or older: united states, 2014 1.

Vaccine Schedule

The varicella vaccine requires a second dose 4-8 weeks after the first dose, as stated in the 2014 guidelines 1. For Hepatitis A, schedule the second dose 6-12 months after the first dose to complete the series.

Typhoid Vaccination Options

For typhoid vaccination, there are two options: the oral Ty21a vaccine (Vivotif), which consists of four capsules taken every other day, or the injectable Vi polysaccharide vaccine (Typhim Vi), which is a single dose.

• The oral typhoid vaccine can be started at any time, but ideally not within 3 days of the other vaccines to monitor for side effects.
• The injectable typhoid vaccine can be given during the initial visit along with the other vaccines.

Duration of Protection and Side Effects

Note that typhoid vaccine protection is relatively short-lived - the oral vaccine provides protection for about 5 years, while the injectable vaccine lasts about 2-3 years. Side effects are generally mild for all these vaccines and may include soreness at the injection site, low-grade fever, and fatigue, as mentioned in the recommendations for other vaccines 1.

Importance of Vaccination

These vaccines are particularly important if you're traveling to regions with higher prevalence of these diseases or if you have specific risk factors such as certain occupations or medical conditions.

From the Research

Vaccine Schedule

To plan a schedule for an adult who wants to take the varicella, Hepatitis A, and Typhoid vaccines, consider the following:

• The varicella vaccine can be administered in two doses, with a recommended interval of 4-8 weeks between doses 2.
• The Hepatitis A vaccine can be administered in two doses, with a recommended interval of 6-12 months between doses, or as a combined vaccine with Typhoid fever vaccine in a single dose 3.
• The Typhoid vaccine can be administered as a single dose, combined with Hepatitis A vaccine, or as a separate vaccine 3, 4.

Considerations

When planning the vaccine schedule, consider the following:

• The varicella vaccine is recommended for adults who are susceptible to varicella-zoster virus (VZV) 2, 5.
• The Hepatitis A and Typhoid vaccines are recommended for adults who are traveling to endemic countries or are at high risk of exposure 3, 4.
• The combined Hepatitis A and Typhoid vaccine offers convenience and rapid seroconversion, with a single dose providing dual protection 3.

Administration

The vaccines can be administered as follows:

• Varicella vaccine: two doses, 4-8 weeks apart 2.
• Hepatitis A and Typhoid combined vaccine: single dose 3.
• Alternatively, the Hepatitis A vaccine can be administered in two doses, 6-12 months apart, and the Typhoid vaccine can be administered as a separate single dose 4.