Typhoid, Oral, Live Attenuated

Typhoid, Oral, Live Attenuated is a vaccine used to prevent typhoid fever in adults and children greater than six years.    

It belongs to a group of drugs called vaccines. They work in the body by inducing a protective immune response against the disease.

Typhoid, Oral, Live Attenuated is available as an enteric-coated capsule. It is typically taken every other day for 4 doses, with a cold or luke-warm drink approximately one hour before a meal.

Vivotif common side effects are stomach pain, nausea, vomiting, fever, and headache. 

Vivotif is a live attenuated (weakened) vaccine given to prevent typhoid in persons two years of age and older.

According to the CDC, routine vaccination with typhoid, oral, live attenuated is not recommended in the United States, but this vaccine is recommended for:

• Travelers to parts of the world where typhoid is common. (NOTE: typhoid vaccine is not 100% effective and is not a substitute for being careful about what you eat or drink).
• People in close contact with a typhoid carrier.
• Laboratory workers who work with Salmonella Typhi bacteria

This vaccine may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Typhoid, Oral, Live Attenuated may be found in some form under the following brand names:

• Vivotif

Serious side effects have been reported with this vaccine. See "Drug Precautions” section.

Common side effects include:

• fever
• headache
• stomach pain
• nausea
• vomiting
• skin rash 

This is not a complete list of side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967 or http://www.fda.gov/vaers

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• antibiotics
• medications to treat malaria
• corticosteroids such as prednisone and dexamethasone
• chemotherapy drugs that weaken the immune system
• organ transplant drugs
• medications used to treat rheumatoid arthritis 

In addition, tell your doctor if you plan to receive live vaccines. 

This is not a complete list of drug interactions. Ask your doctor or pharmacist for more information.

Like any medicine, a vaccine could cause a serious problem, such as a severe allergic reaction. The risk of this vaccine causing serious harm, or death, is extremely small. Serious problems from this vaccine are very rare.

Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would start a few minutes to a few hours after the vaccination.

Do not receive this vaccine if you are allergic to any of its components.

Medications and vaccines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of this vaccine, there are no specific foods that you must exclude from your diet when receiving this vaccination. However, not all interactions are known or reported and new interactions including food can be reported. Always ask your doctor or pharmacist about food interactions.

Before receiving this vaccine, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to typhoid, oral, live attenuated or to any of its ingredients
• (your) child is under 6 years
• you plan on receiving live vaccines
• are receiving antibiotics. Vivotif should not be taken until at least 3 days after taking antibiotics.
• are feeling sick (have a fever). It may be best to wait to receive this vaccine until you feel better
• have an illness involving severe diarrhea and/or vomiting
• have a congenital disease (hereditary or acquired disease or condition that is present at birth)
• if you are pregnant or breastfeeding
• have a weakened immune system. If you have a weakened immune system, this vaccine is not recommended. The typhoid vaccine (Typhim Vi is recommended instead)
  • have HIV/ AIDS or another disease that affects the immune system
  • are being treated with medications that affect the immune system,  e.g. steroids for 2 weeks or longer
  • are receiving chemotherapy or radiation
  • have any type of cancer

Tell your doctor about all the medicines you take including prescription and non­prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.  

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Typhoid, Oral, Live Attenuated falls into category C. Animal reproduction studies have not been conducted with Vivotif and there are no adequate studies in pregnant women. Therefore, it is not known whether this vaccine can cause fetal harm when administered to pregnant women or can affect reproduction capacity. Vivotif should be given to a pregnant woman only if clearly needed.

Tell your doctor if you are breastfeeding or plan to breastfeed your baby.

There are no data regarding administration of this vaccine to nursing mothers. Therefore, it is not known if components of this vaccine crosses into human milk. Because many medications can cross into human milk and because of the possibility for adverse reactions in nursing infants with use of this vaccine, a choice should be made whether to stop nursing and/or start the use of this vaccine. Your doctor and you will decide if the benefits outweigh the risk of using Vivotif while breastfeeding.

Take this vaccine exactly as prescribed.

• Typhoid, Oral, Live Attenuated is available as an enteric-coated capsule.  
• Four doses: one capsule every other day for a week (day 1, day 3, day 5, and day 7). The last dose should be given at least 1 week before travel (possible exposure to S. typhi) to allow the vaccine time to work.
• Swallow each dose about an hour before a meal with a cold or lukewarm drink. Do not chew the capsule.
• A booster dose is needed every 5 years for people who remain at risk.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The recommended dose of Vivotif (typhoid, oral, live attenuated) is 4 doses. Patients should take all 4 doses at least 1 week prior to potential exposure to S. typhi.

If you take too much of this vaccine, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Store capsules in the refrigerator at a temperature between 2 °C–8 °C (35.6 °F–46.4 °F). If the vaccine is left at room temperature, it will lose its effectiveness.
• Keep this and all medicines out of the reach of children.