human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Efficacy and side effects following the immunization with Salmonella typhi Vi capsular polysaccharide vaccine ( Vi ) were assessed . The diluted solution ( DS ) of Vi was used as placebo .  A total number of 777 children and adults were observed for side effect response . Mild and moderate fever appeared 16.93 % and 0.05 % in Vi group , 15.01 % and 0.03 % in DS group , respectively ( statistically significant ) . Two cases with mild local reaction were observed in Vi group . A total number of 81,506 vaccinees were investigated on the efficacy of Vi vaccine , using positive blood culture of Salmonolla typhi as a diagnostic criterion . The protective rate and index of vaccine were 71.35 % and 3.49 % respectively . If 2 cases of positive Widal 's test were included in , the protective rate would come up to 78.17 % with a protective index 4.85 . Clinical data showed that fever seen in the cases in Vi group was much lower than that of DS group . The systematic and local reaction of Vi vaccine were mild . The vaccine is safe and has high protective rate . It can also decrease the degree of fever with only one single dose as primary immunization . We believe Vi vaccine may serve as a vaccine of new generation to be promoted We report the coverage , safety , and logistics of a school-based typhoid fever immunization campaign that took place in Hue City , central Vietnam ; a typhoid fever endemic area . A cluster-r and omized evaluation-blinded controlled trial was design ed where 68 schools ( cluster ) were r and omly allocated the single dose Vi polysaccharide vaccine ( Typherix ) or the active control hepatitis A vaccine ( Havrix ) . A safety surveillance system was implemented . A total of 32,267 children were immunized with a coverage of 57.5 % . Strong predictors for vaccination were attending primary schools , peri-urban location of the school , and low family income . Human re sources were mainly schoolteachers and the campaign was completed in about 1 month . Most adverse events reported were mild . Safe injection and safe sharp-waste disposal practice s were followed . A typhoid fever school-based immunization campaign was safe and logistically possible . Coverage was moderate and can be interpreted as the minimum that could have been achievable because individual written informed consent procedures were sought for the first time in Hue City and the trial nature of the campaign . The lessons learned , together with cost-effectiveness results to be obtained by the end of follow-up period , will hopefully accelerate the introduction of Vi typhoid fever vaccine in Vietnam A field trial was carried out with a vaccine containing 300x10(9 ) killed S. typhi ( strain Ty58 ) per tablet . A total of 12 564 children aged 1 - 15 years were given 3 tablets of the vaccine or a placebo at the rate of one tablet on each of 3 consecutive days . The results indicated that the vaccine , in its present form and at this dosage , gives no protection Abstract In 1960 about 72,000 Guyanese schoolchildren , aged five to fifteen years , were divided into three similar groups , one of which acted as a control and was given tetanus toxoid , the second was given an acetone-killed typhoid vaccine , and the third a heat-killed-phenolised typhoid vaccine . Two subcutaneous doses of 0.5 ml . of reconstituted vaccines were given five weeks apart . An additional 10,000 children received one dose only . The incidence of typhoid fever , diagnosed by the bacteriological isolation of Salmonella typhi , was followed for seven years after vaccination . In those given two doses , 146 cases of typhoid occurred in the control group and 16 and 49 in the acetone and heat-phenol typhoid vaccine groups , showing protection-rates of 88 % and 65 % , respectively . In those given one dose of vaccine the protection was somewhat greater , 22 cases occurring in the control group and 1 and 4 in the groups given the acetone and heat-phenol vaccines , respectively . Protection showed little diminution until the fifth year after vaccination A controlled field trial of a modified vaccine containing Salmonella typhi , TY 2 strain , in a dose of 400 x 10(9 ) killed organisms per capsule , was carried out in schoolchildren aged 6 - 17 years . The children were followed up for 6 - 8 months . There were 66 cases of typhoid fever in the vaccine group ( 7312 children ) and 54 in the control group ( 7292 children who had received a placebo ) . This difference is not statistically significant . The results confirm that , as found in earlier trials , oral typhoid vaccine , in the dosages used so far , gives no protection A typhoid vaccine derived from the purified Vi capsular polysaccharide ( CPS ) antigen of Salmonella typhi was compared with a heat-killed whole-cell typhoid vaccine in 637 healthy male volunteers . The individuals were placed in three groups : group 1 received two doses of heat-killed whole-cell typhoid vaccine , at an interval of 28 days ; group 2 received a single dose of typhoid Vi CPS vaccine followed after 28 days by water for injection ; and group 3 received water for injection on the first occasion and a single dose of typhoid Vi CPS vaccine 28 days later . Local and systemic adverse reactions were recorded for 5 days following each injection . Subjects receiving the typhoid Vi CPS vaccine complained of fewer local adverse reactions on each of the first 3 days following immunization : on day 1 , 18.6 % of subjects given typhoid Vi CPS vaccine reported local reactions compared with 59.7 % of those receiving heat-killed whole-cell vaccine ( P < 0.001 ) . The percentage of subjects receiving the heat-killed whole-cell vaccine who complained of systemic reactions was more than twice that of subjects receiving the Vi CPS vaccine ( 7.9 % and 3.4 % , respectively , on day 1 ; P < 0.01 ) A locally produced Vi polysaccharide vaccine against typhoid fever was licensed in China following two placebo-controlled , efficacy trials conducted in the early 1990s in Baoying , Jiangsu Province , and Quan-zhou , Guangxi Province . The two trials each enrolled over 80,000 participants and followed participants for 12 and 19 months post-vaccination , respectively . To define the long-term efficacy of this vaccine , we retrospectively assessed the occurrence of typhoid fever , diagnosed with clinical and serological criteria , in the two study population s for 6 years following vaccination . During the second year following vaccination , vaccine efficacy was 100 % ( 95 % CI : 17 % , 100 % ) in Baoying and 85 % ( 95 % CI : 49 % , 96 % ) in Quan-zhou . There was suggestive protection ( 51 % ; PE : -95 % , 88 % ) during the third year in Baoying , nearly identical to the level observed in the third year of an earlier trial in South Africa . These results confirm that this vaccine protects for at least 2 years , and are consistent with the assertion that the vaccine protects for at least 3 years Three vaccination trials against typhoid fever were carried out in 1968/69 , 1970/71 and 1974 in New Dehli . The vaccine was generally administered in tablet form on three consecutive days . Each new trial consisted of a larger number of killed bacteria : 100.10(9 ) , then 300.10(9 ) and finally 400.10(9 ) killed S. typhi . The placebo and vaccinated groups were composed of 6,000 to 7,000 persons , sometimes only children from 6 to 17 years . The number of typhoid fever cases which appeared under normal conditions of infection did not show significant difference between the vaccinated and non-vaccinated subjects during the 18 month period of observation ABSTRACT Salmonella enterica serovar Typhi strain CVD 908-htrA is a live attenuated strain which may be useful as an improved oral typhoid vaccine and as a vector for cloned genes of other pathogens . We conducted a phase 2 trial in which 80 healthy adults received one of two dosage levels of CVD 908-htrA  in a double-blind , placebo-controlled , crossover study . There were no differences in the rates of side effects among volunteers who received high-dose vaccine ( 4.5 × 108 CFU ) , lower-dose vaccine ( 5 × 107 CFU ) , or placebo in the 21 days after vaccination , although recipients of high-dose vaccine ( 8 % ) had more frequent diarrhea than placebo recipients ( 0 % ) in the first 7 days . Seventy-seven percent and 46 % of recipients of high- and lower-dose vaccines , respectively , briefly excreted vaccine organisms in their stools . All blood cultures were negative . Antibody-secreting cells producing antilipopolysaccharide ( LPS ) immunoglobulin A ( IgA ) were detected in 100 and 92 % of recipients of high- and lower-dose vaccines , respectively . Almost half the volunteers developed serum anti-LPS IgG. Lymphocyte proliferation and gamma interferon production against serovar Typhi antigens occurred in a significant proportion of vaccinees . This phase 2 study supports the further development of CVD 908-htrA as a single-dose vaccine against typhoid fever and as a possible live vector for oral delivery of other vaccine antigens Helicobacter pylori urease was expressed in the common live typhoid vaccine Ty21a yielding Ty21a(pDB1 ) . Nine volunteers received Ty21a(pDB1 ) and three control volunteers received Ty21a .  No serious adverse effects were observed in any of the volunteers . Ten out of 12 volunteers developed humoral immune responses to the Salmonella carrier as detected by antigen-specific antibody-secreting cells but only two volunteers seroconverted . A total of five volunteers showed responses in one or two out of three assays for cellular responses to the carrier ( proliferation , IFN-gamma-secretion , IFN-gamma-ELISPOT ) . Three of the volunteers that had received Ty21a(pDB1 ) showed a weak but significant T-cell response to Helicobacter urease , while no volunteer had detectable humoral responses to urease . Ty21a(pDB1 ) is a suitable prototype to optimize Salmonella-based vaccination for efficient cellular responses that could mediate protective immunity against Helicobacter Three doses , given within one week , of Ty21a attenuated Salmonella typhi oral vaccine in an enteric-coated formulation provided 67 % efficacy for at least 3 years in a r and omised , placebo-controlled field trial involving 109,000 schoolchildren in Santiago , Chile . Increasing the interval between doses to twenty-one days did not enhance protection . Significantly less protection followed administration of vaccine in gelatin capsules with sodium bicarbonate . Ty21a provides the same level of protection as the heat/phenol-inactivated whole cell parenteral vaccine but differs in not causing adverse reactions .  Ty21a may now be regarded as a practical public health tool Typhoid fever is a major cause of morbidity and mortality in many parts of the world . In view of the increasing resistance of Salmonella typhi against antibiotics and the high costs associated with improving sanitation conditions , vaccination programs would be of great benefit . We report on the evaluation of a new c and i date VI ( sic ) polysaccharide typhoid vaccine ( TypheriX ™ (sic),2 SmithKline Beecham Biologicals ) tested in Filipino children aged 2 - 5 years where the profile was compared with that of a  competitor-vaccine ( Typhim ™ (sic ) , Pasteur Merieux Connaught).Vaccination with the new c and i date vaccine was followed by fewer general symptoms ( 2.9 % ) than with the competitor vaccine ( 14.1 % ) , particularly with lower incidence of fever . The new c and i date vaccine is also highly immunogenic : > 99 % of the vaccinees were immune 28 days post vaccination with comparable GMTs of 3597 EL.U/ml for TypheriX ™ (sic ) and 3365 EL.U/ml for Typhim ™ (sic).This trial shows that the available VI ( sic ) polysaccharide vaccines provide a reliable means in preventing a disease responsible for a significant morbidity and placing a heavy burden on health budgets BACKGROUND Typhoid fever is common in developing countries . The licensed typhoid vaccines confer only about 70 percent immunity , do not protect young children , and are not used for routine vaccination . A newly devised conjugate of the capsular polysaccharide of Salmonella typhi , Vi , bound to nontoxic recombinant Pseudomonas aeruginosa exotoxin A ( rEPA ) , has enhanced immunogenicity in adults and in children 5 to 14 years old and has elicited a booster response in children 2 to 4 years old . METHODS In a double-blind , r and omized trial , we evaluated the safety , immunogenicity , and efficacy of the Vi-r 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Efficacy and side effects following the immunization with Salmonella typhi Vi capsular polysaccharide vaccine ( Vi ) were assessed . The diluted solution ( DS ) of Vi was used as placebo .  A total number of 777 children and adults were observed for side effect response . Mild and moderate fever appeared 16.93 % and 0.05 % in Vi group , 15.01 % and 0.03 % in DS group , respectively ( statistically significant ) . Two cases with mild local reaction were observed in Vi group . A total number of 81,506 vaccinees were investigated on the efficacy of Vi vaccine , using positive blood culture of Salmonolla typhi as a diagnostic criterion . The protective rate and index of vaccine were 71.35 % and 3.49 % respectively . If 2 cases of positive Widal 's test were included in , the protective rate would come up to 78.17 % with a protective index 4.85 . Clinical data showed that fever seen in the cases in Vi group was much lower than that of DS group . The systematic and local reaction of Vi vaccine were mild . The vaccine is safe and has high protective rate . It can also decrease the degree of fever with only one single dose as primary immunization . We believe Vi vaccine may serve as a vaccine of new generation to be promoted We report the coverage , safety , and logistics of a school-based typhoid fever immunization campaign that took place in Hue City , central Vietnam ; a typhoid fever endemic area . A cluster-r and omized evaluation-blinded controlled trial was design ed where 68 schools ( cluster ) were r and omly allocated the single dose Vi polysaccharide vaccine ( Typherix ) or the active control hepatitis A vaccine ( Havrix ) . A safety surveillance system was implemented . A total of 32,267 children were immunized with a coverage of 57.5 % . Strong predictors for vaccination were attending primary schools , peri-urban location of the school , and low family income . Human re sources were mainly schoolteachers and the campaign was completed in about 1 month . Most adverse events reported were mild . Safe injection and safe sharp-waste disposal practice s were followed . A typhoid fever school-based immunization campaign was safe and logistically possible . Coverage was moderate and can be interpreted as the minimum that could have been achievable because individual written informed consent procedures were sought for the first time in Hue City and the trial nature of the campaign . The lessons learned , together with cost-effectiveness results to be obtained by the end of follow-up period , will hopefully accelerate the introduction of Vi typhoid fever vaccine in Vietnam A field trial was carried out with a vaccine containing 300x10(9 ) killed S. typhi ( strain Ty58 ) per tablet . A total of 12 564 children aged 1 - 15 years were given 3 tablets of the vaccine or a placebo at the rate of one tablet on each of 3 consecutive days . The results indicated that the vaccine , in its present form and at this dosage , gives no protection Abstract In 1960 about 72,000 Guyanese schoolchildren , aged five to fifteen years , were divided into three similar groups , one of which acted as a control and was given tetanus toxoid , the second was given an acetone-killed typhoid vaccine , and the third a heat-killed-phenolised typhoid vaccine . Two subcutaneous doses of 0.5 ml . of reconstituted vaccines were given five weeks apart . An additional 10,000 children received one dose only . The incidence of typhoid fever , diagnosed by the bacteriological isolation of Salmonella typhi , was followed for seven years after vaccination . In those given two doses , 146 cases of typhoid occurred in the control group and 16 and 49 in the acetone and heat-phenol typhoid vaccine groups , showing protection-rates of 88 % and 65 % , respectively . In those given one dose of vaccine the protection was somewhat greater , 22 cases occurring in the control group and 1 and 4 in the groups given the acetone and heat-phenol vaccines , respectively . Protection showed little diminution until the fifth year after vaccination A controlled field trial of a modified vaccine containing Salmonella typhi , TY 2 strain , in a dose of 400 x 10(9 ) killed organisms per capsule , was carried out in schoolchildren aged 6 - 17 years . The children were followed up for 6 - 8 months . There were 66 cases of typhoid fever in the vaccine group ( 7312 children ) and 54 in the control group ( 7292 children who had received a placebo ) . This difference is not statistically significant . The results confirm that , as found in earlier trials , oral typhoid vaccine , in the dosages used so far , gives no protection A typhoid vaccine derived from the purified Vi capsular polysaccharide ( CPS ) antigen of Salmonella typhi was compared with a heat-killed whole-cell typhoid vaccine in 637 healthy male volunteers . The individuals were placed in three groups : group 1 received two doses of heat-killed whole-cell typhoid vaccine , at an interval of 28 days ; group 2 received a single dose of typhoid Vi CPS vaccine followed after 28 days by water for injection ; and group 3 received water for injection on the first occasion and a single dose of typhoid Vi CPS vaccine 28 days later . Local and systemic adverse reactions were recorded for 5 days following each injection . Subjects receiving the typhoid Vi CPS vaccine complained of fewer local adverse reactions on each of the first 3 days following immunization : on day 1 , 18.6 % of subjects given typhoid Vi CPS vaccine reported local reactions compared with 59.7 % of those receiving heat-killed whole-cell vaccine ( P < 0.001 ) . The percentage of subjects receiving the heat-killed whole-cell vaccine who complained of systemic reactions was more than twice that of subjects receiving the Vi CPS vaccine ( 7.9 % and 3.4 % , respectively , on day 1 ; P < 0.01 ) A locally produced Vi polysaccharide vaccine against typhoid fever was licensed in China following two placebo-controlled , efficacy trials conducted in the early 1990s in Baoying , Jiangsu Province , and Quan-zhou , Guangxi Province . The two trials each enrolled over 80,000 participants and followed participants for 12 and 19 months post-vaccination , respectively . To define the long-term efficacy of this vaccine , we retrospectively assessed the occurrence of typhoid fever , diagnosed with clinical and serological criteria , in the two study population s for 6 years following vaccination . During the second year following vaccination , vaccine efficacy was 100 % ( 95 % CI : 17 % , 100 % ) in Baoying and 85 % ( 95 % CI : 49 % , 96 % ) in Quan-zhou . There was suggestive protection ( 51 % ; PE : -95 % , 88 % ) during the third year in Baoying , nearly identical to the level observed in the third year of an earlier trial in South Africa . These results confirm that this vaccine protects for at least 2 years , and are consistent with the assertion that the vaccine protects for at least 3 years Three vaccination trials against typhoid fever were carried out in 1968/69 , 1970/71 and 1974 in New Dehli . The vaccine was generally administered in tablet form on three consecutive days . Each new trial consisted of a larger number of killed bacteria : 100.10(9 ) , then 300.10(9 ) and finally 400.10(9 ) killed S. typhi . The placebo and vaccinated groups were composed of 6,000 to 7,000 persons , sometimes only children from 6 to 17 years . The number of typhoid fever cases which appeared under normal conditions of infection did not show significant difference between the vaccinated and non-vaccinated subjects during the 18 month period of observation ABSTRACT Salmonella enterica serovar Typhi strain CVD 908-htrA is a live attenuated strain which may be useful as an improved oral typhoid vaccine and as a vector for cloned genes of other pathogens . We conducted a phase 2 trial in which 80 healthy adults received one of two dosage levels of CVD 908-htrA  in a double-blind , placebo-controlled , crossover study . There were no differences in the rates of side effects among volunteers who received high-dose vaccine ( 4.5 × 108 CFU ) , lower-dose vaccine ( 5 × 107 CFU ) , or placebo in the 21 days after vaccination , although recipients of high-dose vaccine ( 8 % ) had more frequent diarrhea than placebo recipients ( 0 % ) in the first 7 days . Seventy-seven percent and 46 % of recipients of high- and lower-dose vaccines , respectively , briefly excreted vaccine organisms in their stools . All blood cultures were negative . Antibody-secreting cells producing antilipopolysaccharide ( LPS ) immunoglobulin A ( IgA ) were detected in 100 and 92 % of recipients of high- and lower-dose vaccines , respectively . Almost half the volunteers developed serum anti-LPS IgG. Lymphocyte proliferation and gamma interferon production against serovar Typhi antigens occurred in a significant proportion of vaccinees . This phase 2 study supports the further development of CVD 908-htrA as a single-dose vaccine against typhoid fever and as a possible live vector for oral delivery of other vaccine antigens Helicobacter pylori urease was expressed in the common live typhoid vaccine Ty21a yielding Ty21a(pDB1 ) . Nine volunteers received Ty21a(pDB1 ) and three control volunteers received Ty21a .  No serious adverse effects were observed in any of the volunteers . Ten out of 12 volunteers developed humoral immune responses to the Salmonella carrier as detected by antigen-specific antibody-secreting cells but only two volunteers seroconverted . A total of five volunteers showed responses in one or two out of three assays for cellular responses to the carrier ( proliferation , IFN-gamma-secretion , IFN-gamma-ELISPOT ) . Three of the volunteers that had received Ty21a(pDB1 ) showed a weak but significant T-cell response to Helicobacter urease , while no volunteer had detectable humoral responses to urease . Ty21a(pDB1 ) is a suitable prototype to optimize Salmonella-based vaccination for efficient cellular responses that could mediate protective immunity against Helicobacter Three doses , given within one week , of Ty21a attenuated Salmonella typhi oral vaccine in an enteric-coated formulation provided 67 % efficacy for at least 3 years in a r and omised , placebo-controlled field trial involving 109,000 schoolchildren in Santiago , Chile . Increasing the interval between doses to twenty-one days did not enhance protection . Significantly less protection followed administration of vaccine in gelatin capsules with sodium bicarbonate . Ty21a provides the same level of protection as the heat/phenol-inactivated whole cell parenteral vaccine but differs in not causing adverse reactions .  Ty21a may now be regarded as a practical public health tool Typhoid fever is a major cause of morbidity and mortality in many parts of the world . In view of the increasing resistance of Salmonella typhi against antibiotics and the high costs associated with improving sanitation conditions , vaccination programs would be of great benefit . We report on the evaluation of a new c and i date VI ( sic ) polysaccharide typhoid vaccine ( TypheriX ™ (sic),2 SmithKline Beecham Biologicals ) tested in Filipino children aged 2 - 5 years where the profile was compared with that of a  competitor-vaccine ( Typhim ™ (sic ) , Pasteur Merieux Connaught).Vaccination with the new c and i date vaccine was followed by fewer general symptoms ( 2.9 % ) than with the competitor vaccine ( 14.1 % ) , particularly with lower incidence of fever . The new c and i date vaccine is also highly immunogenic : > 99 % of the vaccinees were immune 28 days post vaccination with comparable GMTs of 3597 EL.U/ml for TypheriX ™ (sic ) and 3365 EL.U/ml for Typhim ™ (sic).This trial shows that the available VI ( sic ) polysaccharide vaccines provide a reliable means in preventing a disease responsible for a significant morbidity and placing a heavy burden on health budgets BACKGROUND Typhoid fever is common in developing countries . The licensed typhoid vaccines confer only about 70 percent immunity , do not protect young children , and are not used for routine vaccination . A newly devised conjugate of the capsular polysaccharide of Salmonella typhi , Vi , bound to nontoxic recombinant Pseudomonas aeruginosa exotoxin A ( rEPA ) , has enhanced immunogenicity in adults and in children 5 to 14 years old and has elicited a booster response in children 2 to 4 years old . METHODS In a double-blind , r and omized trial , we evaluated the safety , immunogenicity , and efficacy of the Vi-r 
    Output:
    