Introduction

Class Name(s):

• 80:12 Vaccines

Brand Name(s):

• Vivotif^®
• Typhim VI^®

What is typhoid?

Typhoid (typhoid fever) is a serious disease. It is caused by bacteria called Salmonella Typhi. Typhoid causes a high fever, fatigue, weakness, stomach pains, headache, loss of appetite, and sometimes a rash. If it is not treated, it can kill up to 30% of people who get it. Some people who get typhoid become ''carriers,'' who can spread the disease to others. Generally, people get typhoid from contaminated food or water. Typhoid is rare in the U. S., and most U. S. citizens who get the disease get it while traveling. Typhoid strikes about 21 million people a year around the world and kills about 200,000.

What typhoid vaccines are available?

Typhoid vaccine can prevent typhoid. There are two vaccines to prevent typhoid. One is an inactivated (killed) vaccine given as a shot. The other is a live, attenuated (weakened) vaccine which is taken orally (by mouth).

Who should get typhoid vaccine and when?

Routine typhoid vaccination is not recommended in the United States, but typhoid 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.

Inactivated typhoid vaccine (shot)

• One dose provides protection. It should be given at least 2 weeks before travel to allow the vaccine time to work.
• A booster dose is needed every 2 years for people who remain at risk.

Live typhoid vaccine (oral)

• 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 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. Either vaccine may safely be given at the same time as other vaccines.

Who should not get typhoid vaccine or should wait?

Inactivated typhoid vaccine (shot)

• Should not be given to children younger than 2 years of age.
• Anyone who has had a severe reaction to a previous dose of this vaccine should not get another dose.
• Anyone who has a severe allergy to any component of this vaccine should not get it. Tell your doctor if you have any severe allergies.
• Anyone who is moderately or severely ill at the time the shot is scheduled should usually wait until they recover before getting the vaccine.

Live typhoid vaccine (oral)

• Should not be given to children younger than 6 years of age.
• Anyone who has had a severe reaction to a previous dose of this vaccine should not get another dose.
• Anyone who has a severe allergy to any component of this vaccine should not get it. Tell your doctor if you have any severe allergies.
• Anyone who is moderately or severely ill at the time the vaccine is scheduled should usually wait until they recover before getting it. Tell your doctor if you have an illness involving vomiting or diarrhea.
• Anyone whose immune system is weakened should not get this vaccine. They should get the typhoid shot instead. This includes anyone who: has HIV/AIDS or another disease that affects the immune system, is being treated with drugs that affect the immune system, such as steroids for 2 weeks or longer, has any kind of cancer, or is taking cancer treatment with radiation or drugs.
• Oral typhoid vaccine should not be given until at least 3 days after taking certain antibiotics.

Ask your doctor for more information.

What are the risks from typhoid vaccine?

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

Inactivated typhoid vaccine (shot)

Mild reactions

• Fever (up to about 1 person in 100)
• Headache (up to about 1 person in 30)
• Redness or swelling at the site of the injection (up to about 1 person in 15)

Live typhoid vaccine (oral)

Mild reactions

• Fever or headache (up to about 1 person in 20)
• Stomach pain, nausea, vomiting, rash (rare)

What if there is a serious reaction?

What should I look for?

• Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or behavior changes. 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.

What should I do?

• If you think it is a severe allergic reaction or other emergency that can't wait, call 9-1-1 or get the person to the nearest hospital. Otherwise, call your doctor.
• Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your doctor might file this report, or you can do it yourself through the VAERS web site at http://www.vaers.hhs.gov, or by calling 1-800-822-7967.

VAERS is only for reporting reactions. They do not give medical advice.

How can I learn more?

• Ask your doctor.
• Contact the Centers for Disease Control and Prevention (CDC): Call 1-800-232-4636 (1-800-CDC-INFO) or visit CDC's website at http://www.cdc.gov/vaccines/resources/index.html.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™ Copyright, 2025. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: May 15, 2025.