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Randomized controlled trials involving Vi-TT in individuals under 18 were included. Eligible studies were screened, and quality was assessed using the Cochrane Risk of Bias-2 tool. Meta-analysis was conducted with RevMan Web. Four trials with 111\u2009481 children found the risk of blood culture-confirmed typhoid fever after Vi-TT to be 0.18 compared with nontyphoid vaccines. Adverse event rates were similar, with a serious adverse event risk of 0.82 within six months. Seroconversion was 58.04 times higher at 28 days and 21.80 times higher after 18 months postvaccination, respectively). One trial had a high risk of bias, so sensitivity analysis was performed with and without it. GRADE assessment showed strong evidence that Vi-TT reduces typhoid risk without significant safety concerns. Seroconversion declined over time but remained significantly higher after 18 months. This concludes that Vi-TT is safe and effective for children and adolescents, and is recommended for vaccination in endemic areas.<\/jats:p>","DOI":"10.1177\/10105395251362546","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T13:39:30Z","timestamp":1754919570000},"page":"628-637","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Tetanus-Toxoid Conjugate Typhoid Vaccine (Vi-TT) in Children and Adolescents: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0561-6018","authenticated-orcid":false,"given":"Rajesh","family":"Gyawali","sequence":"first","affiliation":[{"name":"B.P. 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