typhoid vaccine (live), oral

What is the most important information I should know about typhoid vaccine?

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 caused by perforation (forming of a hole), which can be fatal. If the infection spreads to the gallbladder, the infected person may 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 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 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 fever is most common in non-industrialized parts of the world, especially Asia, Africa, and Central or South America. People who travel to those regions are at risk of coming into contact with the disease.

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 areas where the disease is common.

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.

What should I discuss with my healthcare provider before receiving typhoid vaccine?

• fever with any type of infection or illness;
• a weak immune system caused by disease such as HIV/AIDS or cancer; or
• a weak immune system caused by receiving certain medicines such as steroids, chemotherapy or radiation.

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 (Azulfidine, Bactrim, Gantrisin, Septra, SMX-TMP or SMZ-TMP, and others); 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 such as stomach flu or fever, the doctor may ask you to wait until you get better before you can receive the vaccine.

How is typhoid vaccine given?

Typhoid vaccine is recommended for adults and children in the following situations:

• people who travel to countries where typhoid fever is common;
• people who will have long-term exposure to food or water that may be contaminated with typhoid;
• 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.

The typhoid oral vaccine is given in a series of 4 capsules that are taken 1 per day on alternating days (days 1, 3, 5, and 7). On this schedule, you will take 1 capsule every 48 hours for 7 days. Take each capsule according to the recommended schedule or this vaccine may not be effective.

You should complete all doses at least 1 week before your scheduled travel or possible exposure to typhoid.

Swallow the capsule as quickly as possible after placing it in your mouth. Take with a full glass of cold or lukewarm water or other beverage. Do not use warm or hot drinks such as coffee, tea, or warm milk. The liquid you use to help swallow the typhoid vaccine capsule should not be warmer than your body temperature (98.6 degrees F).

The complete series of 4 vaccine capsules should provide protection against typhoid for up to 5 years. Another series of 4 capsules is then recommended every 5 years during possible exposure to typhoid. Your individual booster schedule may be different from these guidelines. Follow your doctor's instructions or the schedule recommended by the Centers for Disease Control and Prevention (CDC).

Be sure you receive all recommended doses of this vaccine. If you do not receive the full series of capsules every 5 years during continued exposure, you may not be fully protected against the disease.

What happens if I miss a dose?

Contact 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 getting typhoid vaccine?

In addition to receiving typhoid 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.

What are the possible side effects of typhoid vaccine?

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:

• fever;
• headache;
• nausea, vomiting, diarrhea, stomach pain; or
• skin rash.

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.

What other drugs will affect typhoid vaccine?

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 interact with typhoid vaccine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

Your doctor or pharmacist can provide more information about this vaccine. Additional information is available from your local health department or the Centers for Disease Control and Prevention.