Typhoid vaccine, live (Oral)

Typhoid fever is a serious illness that can be deadly. It is caused by a germ called Salmonella typhi and is most often spread through contaminated food or water. Typhoid can also spread through close contact with infected people (such as those living in the same household). Some people who are infected may not show any symptoms, but they can still pass the germ to others.

Typhoid fever is very rare in the United States (U.S.) and other places with good water and sewage systems. However, it is a concern in areas that lack these systems. If you are traveling to certain countries or remote regions, the typhoid vaccine can help protect you from typhoid fever. The U.S. CDC advises caution in the following regions:

• Africa
• Asia
• Latin America

The typhoid vaccine taken by mouth helps prevent typhoid fever, but it does not guarantee complete protection. Therefore, it is crucial to avoid infected people and food and water that may be contaminated, even if you have received the vaccine.

To get the best protection against typhoid, you should complete the vaccine dosing schedule (all 4 doses of the vaccine) at least 1 week before traveling to areas where you might be exposed to typhoid.

If you travel regularly to regions where typhoid is a concern, you should get a booster (repeat) dose of the vaccine every 5 years.

The typhoid vaccine is available only from a health care professional.

Tell all of your doctors that you have taken this vaccine if you plan to receive any other live vaccines within 1 month after the last dose.

If you are receiving this vaccine, do not take proguanil (Paludrine(R)) as a single medicine (not available in the United States) for at least 10 days after your last dose.

In deciding to use a vaccine, you and your doctor must consider the risks of the vaccine against its benefits. Here are some important points to think about for this vaccine:

Allergies

Inform your doctor if you have ever had an unusual or allergic reaction to this medicine or any other medicines. Also, let your healthcare professional know about any other allergies you may have, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Typhoid vaccine is not recommended for infants and children up to 6 years old. There is no specific information comparing the use of typhoid vaccine in children 6 years and older with use in other age groups, but it is not expected to cause different side effects or problems in these children than it does in adults.

Geriatric

Many medicines have not been specifically studied in older adults. Therefore, it may not be clear if they work the same way as in younger adults. Although there is no specific information comparing the use of typhoid vaccine in older people with use in other age groups, this vaccine is not expected to cause different side effects or problems in older adults than it does in younger adults.

Breast Feeding

Studies in women suggest that this medicine poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while others may be used together even if an interaction might happen. In these cases, your doctor may change the dose or take other precautions. It is especially important for your healthcare professional to know if you are taking any of the medicines listed below when you receive this vaccine. The following interactions are notable and may not include all possibilities.

Receiving this vaccine with any of the following medicines is not recommended. Your doctor may decide not to use this vaccine or change some of the other medicines you take.

• Deflazacort
• Thiotepa

Receiving this vaccine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Adalimumab
• Alemtuzumab
• Anifrolumab-fnia
• Ansuvimab-zykl
• Antithymocyte Globulin Rabbit
• Axicabtagene Ciloleucel
• Azathioprine
• Baricitinib
• Belatacept
• Bendamustine
• Betibeglogene Autotemcel
• Bimekizumab-bkzx
• Bortezomib
• Bosutinib
• Brexucabtagene Autoleucel
• Brodalumab
• Cabazitaxel
• Canakinumab
• Capecitabine
• Carboplatin
• Carfilzomib
• Carmustine
• Certolizumab Pegol
• Chlorambucil
• Cisplatin
• Cladribine
• Clofarabine
• Cyclophosphamide
• Cyclosporine
• Cytarabine
• Cytarabine Liposome
• Dacarbazine
• Dasatinib
• Daunorubicin
• Daunorubicin Citrate Liposome
• Daunorubicin Liposome
• Deucravacitinib
• Docetaxel
• Doxorubicin
• Dupilumab
• Efgartigimod Alfa-fcab
• Elivaldogene Autotemcel
• Emapalumab-lzsg
• Epirubicin
• Etanercept
• Etoposide
• Etrasimod
• Everolimus
• Fingolimod
• Fludarabine
• Fluorouracil
• Gemcitabine
• Gemtuzumab Ozogamicin
• Golimumab
• Guselkumab
• Hyaluronidase
• Hydroxyurea
• Idarubicin
• Ifosfamide
• Imatinib
• Inebilizumab-cdon
• Infliximab
• Interferon Alfa
• Irinotecan
• Irinotecan Liposome
• Ixekizumab
• Leniolisib
• Lomustine
• Mechlorethamine
• Melphalan
• Mercaptopurine
• Methotrexate
• Mirikizumab-mrkz
• Mitomycin
• Mitoxantrone
• Mycophenolic Acid
• Nelarabine
• Nilotinib
• Ocrelizumab
• Ofatumumab
• Oxaliplatin
• Ozanimod
• Paclitaxel
• Paclitaxel Protein-Bound
• Pemetrexed
• Pentostatin
• Ponatinib
• Ponesimod
• Procarbazine
• Rilonacept
• Risankizumab-rzaa
• Ritlecitinib
• Rituximab
• Rozanolixizumab-noli
• Sarilumab
• Satralizumab-mwge
• Secukinumab
• Siponimod
• Sirolimus
• Spesolimab-sbzo
• Tacrolimus
• Temozolomide
• Teniposide
• Teplizumab-mzwv
• Tildrakizumab-asmn
• Tocilizumab
• Tofacitinib
• Topotecan
• Tositumomab
• Trabectedin
• Tralokinumab-ldrm
• Ublituximab-xiiy
• Upadacitinib
• Ustekinumab
• Valoctocogene Roxaparvovec-rvox
• Vamorolone
• Vinblastine
• Vinorelbine
• Voclosporin

Receiving this vaccine with any of the following medicines may increase the risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Abatacept

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be taken at or around mealtime or with certain types of food because interactions may happen. Using alcohol or tobacco with certain medicines may also cause interactions. Talk to your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical problems may affect the use of this vaccine. Make sure to tell your doctor if you have any other medical issues, especially:

• Diarrhea or
• Fever or
• Other severe illness or
• Severe stomach or intestinal illness or
• Vomiting—These conditions may reduce the effectiveness of the vaccine.

• Immune deficiency condition, including HIV or AIDS—May increase the chance of side effects from the vaccine.

Along with its necessary effects, a medicine may also cause some unwanted effects. Not all of these side effects will occur, but if they do, they may require medical attention.

Check with your doctor immediately if any of the following side effects happen:

• Difficulty with breathing or swallowing
• Hives
• Itching, especially of the feet or hands
• Reddish skin, especially around the ears
• Swelling of the eyes, face, or inside of the nose
• Unusual tiredness or weakness that is sudden and severe

Some side effects may happen that usually do not need medical attention. These side effects might go away during treatment as your body adjusts to the medicine. Your health care professional may also have ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue, are bothersome, or if you have any questions about them:

Less common or rare

• Diarrhea
• Fever
• Nausea
• Skin rash
• Stomach cramps or pain
• Vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your health care professional.

Call your doctor for medical advice about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Vivotif

Available Dosage Forms:

• Capsule
• Capsule, Delayed Release

Therapeutic Class: Vaccine, Live

It is important that all 4 doses of the vaccine be taken exactly as directed. If all the doses are not taken or if doses are not taken at the correct times, the vaccine may not work properly.

The vaccine capsules are meant to dissolve in the intestines. Therefore, they should be inspected to make sure that they are not broken or cracked when you take them. If any are broken or cracked, you will need to replace them.

Typhoid vaccine must be stored in the refrigerator at a temperature between 2 and 8 degrees C (35.6 and 46.4 degrees F) at all times. If the vaccine is left at room temperature, it will lose its effectiveness. Therefore, remember to replace unused vaccine in the refrigerator between doses.

Each dose of the vaccine should be taken approximately 1 hour before a meal. Take with a cold or lukewarm drink that has a temperature that does not exceed body temperature (eg, 37 degrees C or 98.6 degrees F).

Swallow the capsule whole. Do not chew it before swallowing. Also swallow the capsule as soon as possible after you place it in your mouth.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• Take 1 capsule by mouth every other day for a total of 4 doses.

Missed Dose

Call your doctor or pharmacist for instructions.

If you do not remember the missed dose until the next day, take the missed dose at that time and reschedule your every-other-day doses from then. It is important that this vaccine be taken exactly as directed so it can give you the most protection against typhoid fever.

Storage

Store in the refrigerator. Do not freeze.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.