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Peer-Reviewed Publication
N Engl J Med2025;393(17):1704-1714.October 30, 2025Clinical Trial, Phase II

Safety, Efficacy, and Immunogenicity of a Salmonella Paratyphi A Vaccine.

Naina McCann1,2, Margarete Paganotti Vicentine1,2, Narges Ebrahimi1,2, Melanie Greenland1,2, Brian Angus1,2, Andrea M Collins3,4, Thomas Darton5, Katherine Emary1,2, Saul N Faust6,7, Amy Flaxman1,2, Noshi Maria1,2, Christopher A Green8, Claudia Juarez Molina1,2, Ravindra Paidisetti9, Rajeka Lazarus10,11, Grace C Macaulay1,2, Florence McLean1,2, V Krishna Mohan9, M Gangadhara Naidu9, Maheshi N Ramasamy1,2,12, D Yogeswara Rao9, Nisha Singh1,2, Sophie Vernon1,2, Young Chan Kim1,2, Myron M Levine13, Xinxue Liu1,2, Andrew J Pollard1,2,
1Oxford Vaccine Group, Department of Paediatrics, Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Oxford, United Kingdom.
2National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre, Oxford, United Kingdom.
3Liverpool University Hospitals Foundation Trust, Liverpool, United Kingdom.
4Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
5Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom.
6NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
7Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, United Kingdom.
8NIHR-Wellcome Clinical Research Facility, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
9Bharat Biotech International, Hyderabad, India.
10Bristol Medical School, University of Bristol, Bristol, United Kingdom.
11U.K. Health Security Agency Southwest Regional Laboratory and Vaccine Development and Evaluation Centre, Bristol, United Kingdom.
12Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
13Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore.

Abstract

BACKGROUND: Salmonella enterica serovar Paratyphi A (also known as S. Paratyphi A) is responsible for more than 2 million cases of enteric fever annually. There are no licensed vaccines against S. Paratyphi A. METHODS: In a double-blind, randomized, placebo-controlled trial, we evaluated an orally administered live, attenuated S. Paratyphi A vaccine (CVD 1902) using a controlled human infection m…

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