What is Vivotif used for?

• Preventing typhoid in adults and children aged six years and over.

This vaccine is not given routinely - it is recommended for people travelling to areas with a high risk of typhoid.

How does Vivotif work?

Vivotif is an oral typhoid vaccine that contains live, attenuated (weakened) cells of the bacteria that cause typhoid fever (Salmonella typhi). It works by stimulating the body's immune response to these bacteria, without actually causing the disease.

When the body is exposed to foreign organisms such as bacteria, the immune system produces antibodies against them. Antibodies help the body recognise and kill the foreign organisms. The antibodies remain in the body to help protect the body against future infections with the same organism. This is known as active immunity.

The immune system produces different antibodies for each foreign organism it encounters. This establishes a pool of antibodies that helps protect the body from various different diseases.

 This typhoid vaccine stimulates the body to produce antibodies against the bacteria that cause typhoid. There are three doses to take and it takes 7-10 days for protective levels of antibodies to be produced after completing this course.

How do I take Vivotif?

• There are three capsules to take. You should take One Vivotif capsule every other day, for example on Monday, Wednesday and Friday.
• Each capsule should be swallowed whole, approximately one hour before a meal, with a cold or lukewarm (no warmer than body temperature) drink. The capsule should not be chewed and should be swallowed as soon as possible after placing in the mouth.
• It's best to take the course at least two weeks before travel.
• If you are repeatedly exposed to the bacteria, for example by living in or travelling frequently to a high risk area, this vaccine should protect you from typhoid for about three years. However, if you are only occasionally travelling to high risk areas you will need to take a three dose booster course of Vivotif every year to provide continued protection against typhoid.

What should I know before taking Vivotif?

• Vivotif capsules should be stored in a refrigerator at 2-8°C and protected from strong light. Keep out of the reach of children.
• This vaccine will only prevent typhoid fever caused by Salmonella typhi bacteria. It won't prevent paratyphoid fever or infections with any other forms of Salmonella bacteria. As with all vaccines, Vivotif may not protect 100 per cent of people who take the vaccine. You should still observe strict food, water and personal hygiene measures to avoid the disease. These include washing hands before eating or preparing food, only drinking boiled or sterilised water, avoiding ice cubes in drinks unless you know they were made from 'safe water', eating only freshly prepared hot food that has not been allowed to stand at room temperature for many hours, and avoiding raw fruit and vegetables unless you have peeled them yourself. Be careful eating food from street stalls. Measures such as these can also protect you from paratyphoid, hepatitis A, cholera and other types of travellers diarrhoea. Ask your pharmacist for more advice.

Who should not take Vivotif ?

• People who have an underactive immune system, for example due to a genetic defect, disease such as HIV infection, or treatment with immunosuppressant medicines such as chemotherapy, radiotherapy, high-dose corticosteroids, or immunosuppressants, for example used following an organ transplant. People with an underactive immune system can have the injected typhoid vaccine (see end of page).
• People with a sudden feverish illness. (The vaccine should be postponed until after recovery.)
• People with a sudden stomach or intestinal illness, eg vomiting or diarrhoea. (The vaccine should be postponed until after recovery.)
• People who are allergic to any ingredients of Vivotif capsules.

Can I take Vivotif while pregnant or breastfeeding?

Certain vaccines should not be used during pregnancy or breastfeeding. However, other vaccines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before having any vaccines.

• The safety of Vivotif for use during pregnancy and breastfeeding has not been established. It is not recommended for women who are pregnant or breastfeeding unless considered essential by your doctor. It should only be used if the potential benefits are considered to outweigh any risks to the baby. 
• Get medical advice from your doctor before having a typhoid vaccine if you are or think you could be pregnant, or you are breastfeeding. 
• The injected typhoid vaccine is more appropriate for women who are pregnant or breastfeeding, because it is an inactivated vaccine.

What are the possible side effects of Vivotif?

Vaccines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with Vivotif. Just because a side effect is stated here does not mean that all people using this vaccine will experience that or any side effect.

Common (affect between 1 in 10 and 1 in 100 people)

• Abdominal pain.
• Diarrhoea.
• Nausea and vomiting.
• Fever.
• Flu-like symptoms.
• Headache.
• Rash or itching.

Very rare (affect fewer than 1 in 10,000 people)

• Feeling weak, tired or generally unwell.
• Dizziness.
• Aching muscles or joints.
• Allergic reactions, eg anaphylaxis.

If you think you have experienced a side effect from a vaccine you should get advice from your doctor, nurse or pharmacist. If they think it's necessary they'll report it for you. Did you know you can also report side effects yourself using the yellow card website?

Can I take Vivotif with other medicines or vaccines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start taking this vaccine course. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this vaccine, to make sure that the combination is safe.

Vivotif should not be taken by people taking medicines that suppress the activity of the immune system, such as chemotherapy, high-dose corticosteroids, or immunosuppressants (for example used following an organ transplant).

Vivotif should not be taken by people taking antibiotics, as these may inactivate the vaccine. If you are taking an antibiotic you should not start taking this vaccine until at least three days after you have finished the course of antibiotic. It is also preferable that a course of antibiotics is not started until at least three days after you have finished taking the vaccine.

If you also need to take malaria tablets for your travel, it is recommended that you complete the course of Vivotif at least three days before you start taking the antimalarial, because the antimalarial could inactivate the vaccine. An exception to this is the antimalarial Malarone, which can be taken at the same time as Vivotif.

If you have been prescribed mefloquine (Lariam) to prevent malaria and it is not possible to wait until you have finished the vaccine course before you start taking it, the doses of mefloquine and Vivotif must be separated by at least 12 hours.

What other typhoid vaccines are available?

People who can't take this live oral vaccine (for example, people with a suppressed immune system) can be given the injected typhoid vaccine, which is inactivated. 

It's also possible to be vaccinated against typhoid with a combined hepatitis A and typhoid vaccine.

Last updated 20.06.2016