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Typhoid vaccine (live), oral

Generic Name: typhoid vaccine (live), oral (TYE foid vax EEN)
Brand Name: Vivotif Berna

Medically reviewed on Apr 16, 2018

What is typhoid vaccine?

Typhoid (also called "typhoid fever") is a serious disease caused by Salmonella typhi bacteria. Untreated typhoid infection may lead to kidney failure, or intestinal bleeding, which can be fatal. If the infection spreads to your gallbladder, you could become a chronic carrier of the bacteria that causes typhoid. A carrier may have no symptoms but is capable of spreading the infection to others.

Typhoid is spread through contact with the stool (bowel movements) of a person infected with the bacteria. This usually occurs by eating food or drinking water that has become contaminated with feces from an infected person. Once in the digestive tract, typhoid infection can spread to the blood and other parts of the body.

Typhoid can cause high fever, muscle aches, severe headache, weakness, confusion or agitation, loss of appetite, stomach pain, diarrhea or constipation, and rose-colored spots on the skin.

Typhoid vaccine is used to help prevent this disease in adults and children who are at least 6 years old. Although not part of a routine immunization schedule in the U.S., typhoid vaccine is recommended for:

  • people who travel to area where typhoid fever is common (non-industrialized parts of the world, especially Asia, Africa, and Central or South America);

  • people who live with someone who is a typhoid carrier; and

  • laboratory workers who may come into contact with Salmonella typhi in a work setting.

This vaccine works by exposing you to a small amount of the bacteria, which causes your body to develop immunity to the disease.

Typhoid vaccine will not treat an active infection that has already developed in the body, and will not prevent any disease caused by bacteria other than Salmonella typhi.

Like any vaccine, the typhoid vaccine may not provide protection from disease in every person.

Important Information

You should not receive this vaccine if you are sick with a fever or any type of infection, or a weak immune system caused by disease or by using certain medicine.

Before taking this medicine

You should not receive this vaccine if you have ever had an allergic reaction to typhoid vaccine in the past, or if you have:

  • a fever with any type of infection or illness; or

  • weak immune system caused by disease or by using certain medicine.

If you have any of these other conditions, your vaccine may need to be postponed or not given at all:

  • stomach flu or any illness with vomiting or diarrhea;

  • if you are taking an antibiotic, especially a sulfa drug; or

  • if you plan to start taking anti-malaria medicine within 10 days after receiving a typhoid oral vaccine.

You can still receive a vaccine if you have a minor cold. In the case of a more severe illness with a fever or any type of infection, wait until you get better before receiving this vaccine.

It is not known whether typhoid vaccine will harm an unborn baby. However, if you are at a high risk for infection with typhoid fever during pregnancy, your doctor should determine whether you need this vaccine.

It may not be safe to breast-feed a baby while you are using typhoid vaccine (live), oral. Ask your doctor about any risks.

How should I take typhoid vaccine?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

The typhoid oral vaccine is given in a set of 4 capsules. Take 1 capsule every other day at the same time of the day, such as when you first wake up.

You will take a capsule every other day for 7 days. You will need to skip a day between capsules. Follow all instructions on the medicine package.

Take this medicine with a full glass of cool or lukewarm water. Avoid very hot or cold water, which could cause the capsule to dissolve too quickly.

Swallow the capsule as quickly as possible after placing it in your mouth.

Swallow the capsule whole and do not crush, chew, break, or open it.

Take the capsule on an empty stomach, at least 1 hour before eating. Taking a capsule while there is food in your stomach could destroy the capsule and make the vaccine ineffective.

Take each capsule according to the recommended schedule or this vaccine may not be effective. Plan ahead so that you complete all doses at least 1 week before you enter a typhoid risk area. The timing of this vaccination is very important for it to be effective.

You must keep typhoid vaccine capsules cold. When you receive the capsules, place them in a refrigerator as soon as possible. Keep each capsule in the foil blister pack in the refrigerator until you are ready to take it. Do not allow the capsules to freeze.

This vaccine should be effective for up to 5 years. You may need to take another series of 4 capsules every 5 years if you continue to be exposed to typhoid. Follow your doctor's instructions or the schedule recommended by the Centers for Disease Control and Prevention (CDC).

Wash your hands often to help prevent typhoid when you are in an area where contamination is possible.

What happens if I miss a dose?

Call your doctor if you forget to take a capsule on the scheduled day. You may need to start over to make sure you are fully protected against the disease.

Be sure to receive another series of 4 capsules every 5 years during continued exposure to typhoid.

What happens if I overdose?

An overdose of this vaccine is unlikely to occur when taken as directed.

What should I avoid before or after using typhoid vaccine?

Avoid eating anything for at least 1 hour after you take a capsule.

Do not drink alcohol within 2 hours after you take a typhoid vaccine capsule. Alcohol can damage the capsule and could make the vaccine ineffective.

In addition to using this vaccine, take precautions while traveling to further prevent coming into contact with bacteria that cause typhoid fever:

  • Avoid eating leafy vegetables such as spinach or lettuce, which are harder to wash properly.

  • Avoid eating raw fruits or vegetables that cannot be peeled, or that have been peeled by another person.

  • Avoid drinks that contain ice, or frozen treats and flavored ices that may have been made with contaminated water.

  • Avoid eating foods you have not cooked or prepared yourself. Use clean surfaces and utensils when preparing food.

  • Drink only bottled water (carbonated is best) or water that has been boiled for at least 1 minute.

  • Avoid any food or beverage purchased from a street vendor.

Typhoid vaccine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Becoming infected with typhoid fever is much more dangerous to your health than receiving this vaccine. However, like any medicine, this vaccine can cause side effects but the risk of serious side effects is extremely low.

Common side effects include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.

Typhoid vaccine (live), oral dosing information

Usual Adult Dose for Typhoid Prophylaxis:

1 capsule orally, on days 1, 3, 5, and 7, 1 hour before a meal, with cold or lukewarm fluids

Comments:
-The course should be completed at least 1 week before potential exposure to S. typhi.
-Efficacy has been shown to persist for at least 5 years
-Routine immunization is not recommended.
-Immunization is recommended for travelers to areas with a recognized risk, persons with close exposure to a S. typhi carrier, and laboratory workers who work frequently with S. typhi.

Usual Pediatric Dose for Typhoid Prophylaxis:

6 years and older:
1 capsule orally, on days 1, 3, 5, and 7, 1 hour before a meal, with cold or lukewarm fluids

Comments:
-The course should be completed at least 1 week before potential exposure to S. typhi.
-Efficacy has been shown to persist for at least 5 years
-Routine immunization is not recommended.
-Immunization is recommended for travelers to areas with a recognized risk, persons with close exposure to a S. typhi carrier, and laboratory workers who work frequently with S. typhi.

What other drugs will affect typhoid vaccine?

Before using this vaccine, tell your doctor about all other vaccines you have recently received.

You should not take an anti-malaria medicine that contains proguanil (such as Malarone) for at least 10 days after you have received your last dose of typhoid vaccine. Proguanil may make typhoid vaccine less effective.

Other drugs may affect typhoid vaccine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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