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Frequently Asked Questions

Get answers and information about typhoid fever and VIVOTIF.

About typhoid fever

What is typhoid fever?

Typhoid fever is a disease caused by a type of bacteria called Salmonella enterica serovar Typhi.1 Typhoid fever can be a severe and even life-threatening illness.1 An estimated 11 to 21 million cases of typhoid fever occur worldwide each year.1

How do I get typhoid fever?

Typhoid fever is spread through contaminated food or water and by person-to-person contact.1 For example, you can get typhoid fever if you eat or drink something that has been touched by someone who is still getting rid of the Salmonella Typhi bacteria in their feces (stools) – especially if they haven’t washed their hands well after going to the bathroom.1 You can also contract typhoid fever if sewage that has the bacteria in it gets into something you eat or drink, or if it gets into the water used to rinse food that you eat raw.1

What are the symptoms of typhoid fever?

Symptoms of typhoid fever include headache, fever, chills, constipation, skin rash, muscle aches, and a general feeling of discomfort.2,3 In severe cases, confusion, delirium, abdominal pain, or death may occur.3 The symptoms of typhoid fever may vary from person to person. And remember, you can still pass on typhoid fever to others even after your symptoms are gone.2

Where am I most at risk for typhoid fever?

Typhoid fever is common in many regions of the world, including parts of East and Southeast Asia, Africa, and Central and South America.4 However, typhoid fever is also not isolated to only remote locations. You can also be at risk closer to home, in places such as the Caribbean.4

The Centers for Disease Control and Prevention (CDC) recommends vaccination for people traveling to places where typhoid fever is common.5

How can I protect myself against typhoid fever?

The Centers for Disease Control and Prevention (CDC) recommends a typhoid fever vaccination for people traveling to places where typhoid fever is common.5 Talk to your healthcare provider or pharmacist about getting vaccinated before you travel. Want to find a provider in your area? Click here.

Immunization is one of the best ways to help protect you and your family from typhoid fever.5

Typhoid fever vaccines are not 100% effective. Always practice safe eating and drinking habits to help prevent infection.5

You should follow the CDC guidelines for safe eating and drinking overseas where typhoid fever is common. These precautions include4:

  • Only eating food that is cooked and served hot
  • Drinking only bottled water
  • Avoiding ice
  • Avoiding raw or undercooked meat or fish

How is typhoid fever treated?

Typhoid fever is treated with antibiotics.2 However, 71% of Salmonella Typhi infections are resistant to the most common form of antibiotic used to treat typhoid fever, so treatment options are diminishing.6

About VIVOTIF

What is VIVOTIF used for?

VIVOTIF is a prescription vaccine you take by mouth to help protect you from typhoid fever.7 It is the only FDA-approved oral vaccine for typhoid fever.8

Children under the age of 6 should not take VIVOTIF.

Do not use VIVOTIF if you are allergic to any of the ingredients in the vaccine or the
enteric-coated capsule.7

Do not take VIVOTIF if you have an active fever or if your immune system is weakened by a disease or other medicines you take.7

Do not take VIVOTIF if you have sudden stomach or intestinal illness.7

The most common side effects of VIVOTIF are abdominal pain, nausea, headache, fever, diarrhea, vomiting, and skin rash. Only nausea was more common in people who took VIVOTIF compared with those who took a sugar pill.8

These are not all the possible side effects of VIVOTIF. Talk to your healthcare provider about any side effects you experience.

How is VIVOTIF given?

VIVOTIF is the only FDA-approved oral vaccine for typhoid fever.8 The full dosing schedule is 4 capsules that you take by mouth every other day over the course of 7 days.7

Be sure to complete your last dose at least 1 week before you plan to travel.7

How long may VIVOTIF protection last?

VIVOTIF can help provide protection against typhoid fever for up to 5 years.7

The full immunization course is 4 doses.7 The optimum booster schedule for VIVOTIF has not been determined.7

It is recommended that a re-immunization dose consisting of 4 vaccine capsules taken on alternate days be given every 5 years under conditions of repeated or continued exposure to typhoid fever.7

Not all recipients of VIVOTIF will be fully protected against typhoid fever.7

Tell your healthcare provider if you have sudden stomach or intestinal illness. If you are vomiting or have diarrhea that will not stop, do not take VIVOTIF until the vomiting and diarrhea have stopped.7

How does VIVOTIF work?

VIVOTIF is an "active," or "live," vaccine.7 VIVOTIF is thought to work by triggering your own immune system to produce antibodies to the Salmonella Typhi bacteria.9 The VIVOTIF vaccine is contained in a special type of capsule that is designed to remain intact until it reaches your small intestine. Once there, it becomes activated and starts to protect you against typhoid fever.7 The precise ways that VIVOTIF provides protection against typhoid fever are unknown.7

Can VIVOTIF protect me from typhoid fever if I have already been infected?

No. VIVOTIF is not a treatment for typhoid fever and will not protect you from getting sick if you’ve already been infected.7 Additionally, VIVOTIF will not protect you from Salmonella bacteria other than Salmonella Typhi.7

Will I be completely protected from typhoid fever following vaccination with VIVOTIF?

Not all people will be fully protected from typhoid fever following vaccination.7 While you travel, you should take care to ensure the food you eat and water you drink are safe.7 VIVOTIF will not protect you from other kinds of Salmonella bacteria and will not treat typhoid fever if you have been infected.7

It is unknown whether VIVOTIF protects from common source outbreaks of typhoid fever, disease following natural disasters, or in people attending rural summer camps.7

Who can use VIVOTIF?

VIVOTIF is for adults and children ages 6 and older.7 Immunization with VIVOTIF is not routinely recommended for people living in the United States.7 However, VIVOTIF is recommended for people who are at a higher risk of getting typhoid fever. This includes7:

  • People who travel to places where typhoid fever is more common
  • People who have close contact with someone who has had typhoid fever
  • People who work in laboratories who could have contact with typhoid fever

Who shouldn’t take VIVOTIF?

Children under the age of 6 should not take VIVOTIF.7 In addition, DO NOT take VIVOTIF if7:

  • You have an active fever or if your immune system is weakened by a disease or other medicines you take
  • You are allergic to any of the ingredients in the vaccine or in the enteric-coated capsule
  • You have sudden stomach or intestinal illness

How do I get VIVOTIF?

VIVOTIF is available by prescription from your healthcare provider or from select pharmacies. If you are planning an overseas trip, talk with your healthcare provider or pharmacist to see if VIVOTIF is right for you.

How long before my trip should I take VIVOTIF?

You should start taking VIVOTIF at least 2 weeks prior to your trip, so that you can complete your final dose at least 1 week before you plan to travel.5,7

Taking VIVOTIF

How do I take VIVOTIF?

A package of VIVOTIF contains 4 capsules that you take every other day before meals.7 Swallow 1 capsule about 1 hour before a meal with a cold or lukewarm drink.7 It doesn’t matter what time you take your capsule, as long as it’s at least 1 hour before a meal.7 Your healthcare provider or pharmacist will explain the dosing and administration to you.7

Remember7:

  • Capsules should be taken whole and do not chew or break capsules
  • Keep capsules refrigerated
  • All 4 doses of VIVOTIF should be taken at least 1 week before traveling

Need help remembering to take your dose of VIVOTIF? Simply text TRAVEL to 1-833-207-3377 when you take your first dose.

You’ll receive text messages over the next 7 days reminding you to take the remaining doses every other day.

What if I miss a dose of VIVOTIF?

It’s important to take VIVOTIF exactly as your healthcare provider or pharmacist tells you. VIVOTIF may not fully protect you from typhoid fever if you miss a dose.7 In case you miss a dose of VIVOTIF, contact your healthcare provider or pharmacist for instructions.

For full instructions on how to take VIVOTIF, see full Prescribing Information.

What are the most common side effects of VIVOTIF?

The most common side effects seen in initial clinical studies were abdominal pain, nausea, headache, fever, diarrhea, vomiting, and skin rash.7 to: "Data collected (between 1991 and 1995) after approval of the vaccine, in which over 60 million doses were given, showed that side effects were infrequent or mild.7
See full Prescribing Information here.

How should VIVOTIF be stored?

VIVOTIF capsules need to be stored in your refrigerator.7 Be sure to only take out 1 capsule at a time, and keep the rest refrigerated until you have used them all. Do not freeze the capsules.7

Important Facts About VIVOTIF (vee-voh-TEEF).
It is also known as Typhoid Vaccine, Live, Oral Ty21a.

What is VIVOTIF used for?

VIVOTIF is a prescription vaccine you take by mouth to help protect you from typhoid fever. Typhoid is a disease caused by a type of bacteria called Salmonella enterica serovar Typhi. VIVOTIF is for adults and children ages 6 and older.

Immunization with VIVOTIF is not routinely recommended for people living in the United States. However, VIVOTIF is recommended for people who are at a higher risk of getting typhoid. This includes:

  • People who travel to places where typhoid is more common
  • People who have close contact with someone who has had typhoid
  • People who work in laboratories who could have contact with typhoid

Not all people will be fully protected from typhoid following vaccination. While you travel, you should take care to ensure the food you eat and water you drink are safe.

It is unknown whether VIVOTIF protects from common source outbreaks of typhoid, disease following natural disasters, or in people attending rural summer camps.

VIVOTIF will not protect you from other kinds of Salmonella bacteria and will not treat typhoid fever if you have been infected.

Who should not take VIVOTIF?

Children under the age of 6 should not take VIVOTIF.

Do not use VIVOTIF if you are allergic to any of the ingredients in the vaccine or the
enteric-coated capsule.

Do not take VIVOTIF if you have an active fever or if your immune system is weakened by a disease or other medicines you take.

Warnings

Can I take VIVOTIF if I have a stomach or intestinal illness?

Tell your healthcare provider (HCP) if you have sudden stomach or intestinal illness. If you are vomiting or have diarrhea that will not stop, do not take VIVOTIF until the vomiting and diarrhea have stopped.

What should I know about how VIVOTIF works?

It is important to take VIVOTIF exactly as your HCP tells you. VIVOTIF may not fully protect you from typhoid if you miss a dose.

Not everyone that takes VIVOTIF will be fully protected against typhoid.

Can I take VIVOTIF if I take other medications?

Tell your HCP about all the prescription and over-the-counter medicines, vitamins, and herbal supplements you take.

Taking VIVOTIF with certain other medications may affect how VIVOTIF works and may cause
side effects.

What are the most common side effects of VIVOTIF?

The most common side effects of VIVOTIF are abdominal pain, nausea, headache, fever, diarrhea, vomiting, and skin rash. Only nausea was more common in people that took VIVOTIF compared with those who took a sugar pill.

These are not all the possible side effects of VIVOTIF. Talk to your healthcare provider about any side effects you experience.

You can report side effects to the FDA at 1-800-822-7967 or vaers.hhs.gov.

Learn more

This summary provides basic information about VIVOTIF, but it does not include all information known about this vaccine. Talk to your HCP or pharmacist about this information. Your HCP is the best person to help you decide if VIVOTIF is right for you.

VIV CON ISI 01/2021

For more information about VIVOTIF, please see full Prescribing Information.

References

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