Does Vivotif (typhoid vaccine) cause side effects?

Vivotif (typhoid vaccine) is a live attenuated (weakened) oral typhoid vaccine used to prevent typhoid fever

Typhoid disease is caused by ingestion of Salmonella typhi strains from contaminated food or water. Active immunity from vaccine is occurs when the body produces antibodies to typhoid in response to the weakened typhoid bacteria in the vaccine. Vivotif oral typhoid vaccine produces a local response in the intestines, boosting immunity.

Common side effects of Vivotif include:

Vivotif has no listed serious side effects. 

Drug interactions of Vivotif include the following because they significantly lower the effectiveness of typhoid vaccine:

Vivotif should be used with caution with medications like the following because they lower beneficial effect of typhoid vaccine: 

Anti-malaria drugs have anti-bacterial activity, which may interfere with the immunogenicity of Vivotif vaccine. 

There are no adequate studies done on Vivotif to determine safe and effective use in pregnant women. It is unknown if Vivotif enters breast milk; therefore, it is best to be cautious while breastfeeding. Consult your doctor.

What are the important side effects of Vivotif (typhoid vaccine)?

Side effects of typhoid vaccine are:

Vivotif (typhoid vaccine) side effects list for healthcare professionals

More than 1.4 million doses of Ty21a have been administered in controlled clinical trials and more than 150 million doses of Vivotif (Typhoid Vaccine Live Oral Ty21a) have been marketed worldwide.

Active surveillance for adverse reactions of enteric-coated capsules was performed in a pilot study (21) and in a subgroup of a large field trial (14) involving a total of 483 individuals receiving 3 vaccine doses.

The overall symptom rates from both studies when vaccinated with capsules were combined and shown to be:

Only the incidence of nausea occurred at a statistically higher frequency in the vaccinated group as compared to the placebo group (14). Administration of vaccine doses more than 5- fold higher than the currently recommended dose caused only mild reactions in an open study involving 155 healthy adult males (16).

Post-marketing surveillance has revealed that adverse reactions are infrequent and mild (17). Adverse reactions reported to the manufacturer during 1991–1995, during which time over 60 million doses (capsules) were administered, included:

  • diarrhea (N = 45),
  • abdominal pain (N = 42),
  • nausea (N = 35),
  • fever (N = 34),
  • headache (N = 26),
  • skin rash (N = 26),
  • vomiting (N = 18), or
  • urticaria in the trunk and/or extremities (N = 13).

One isolated, non-fatal anaphylactic shock considered to be an allergic reaction to the vaccine was reported.

To report SUSPECTED ADVERSE REACTIONS, contact PaxVax, Inc. at 1-800-533-5899 http://www.paxvax.com; or contact the Vaccine Adverse Event Reporting System (VAERS) at 1-800- 822-7967 or http://www.fda.gov/vaers

What drugs interact with Vivotif (typhoid vaccine)?

  • Several anti-malaria drugs, such as mefloquine, chloroquine and proguanil (not approved for use in US) possess anti-bacterial activity which may interfere with the immunogenicity of Vivotif (17,18).
  • To determine the effect of these anti-malaria drugs on the humoral IgG or IgA anti-S. typhi immune response, healthy adult subjects were given mefloquine (250 mg at weekly intervals; N = 30) chloroquine (500 mg at weekly intervals; N = 30) or proguanil (200 mg daily; N = 30) together with the S. typhi Ty21a vaccine strain (19).
  • Concomitant treatment with mefloquine or chloroquine did not result in a significant reduction in the serum anti-S. typhi immune response compared to subjects receiving vaccine strain only (N = 45).
  • The simultaneous administration of proguanil did effect a significant decrease in the immune response rate. These findings indicate that mefloquine and chloroquine can be administered together with Vivotif.
  • Proguanil should be administered only if 10 days or more have elapsed since the final dose of Vivotif was ingested.
  • The concomitant administration of oral polio vaccine or yellow fever vaccine does not suppress the immune response elicited by the Ty21a vaccine strain (19).
  • There are no data regarding simultaneous administration of other parenteral vaccines or immunoglobulins with Vivotif.

Summary

Vivotif (typhoid vaccine) is a live attenuated (weakened) oral typhoid vaccine used to prevent typhoid fever. Common side effects of Vivotif include abdominal pain, nausea, fever, headache, diarrhea, vomiting, and skin rash. Vivotif has no listed serious side effects. There are no adequate studies done on Vivotif to determine safe and effective use in pregnant women. It is unknown if Vivotif enters breast milk; therefore, it is best to be cautious while breastfeeding. Consult your doctor.

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