Severe systemic reactions to typhoid vaccination: two cases and a review of the literature.

Typhoid vaccination is part of the routine immunization of all military personnel on mobility status. We report the cases of Air Force students who presented to our facility with presumed systemic reactions to the typhoid vaccine much more severe than those commonly reported. Review of the literature reveals that an influenza-like reaction of variable severity commonly occurs in these patients, and in addition there are isolated reports of more severe reactions. These findings shed doubt on the overall safety of the currently used vaccine and warrant a consideration of its abandonment. Several safer alternatives, including the new live oral vaccine used in Europe, are discussed.