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Live oral attenuated typhoid vaccine (Ty21a)

Typhoid vaccine (live)

Brand names: Vivotif

Adult dose

Dose: 1 capsule PO on days 1, 3, 5; ≥1h before food. Booster every 3 years
Route: PO
Frequency: x3 doses

Clinical pearls

  • Travellers — oral alternative to IM vaccine
  • Maintain 2-8°C; complete ≥1 week before travel

Contraindications

  • Children <6 (5 in some)
  • Immunosuppression
  • Pregnancy
  • Acute GI illness
  • Recent antibacterials (separate by 3 days)

Side effects

  • GI upset
  • Headache
  • Rash
  • Fever

Interactions

  • Antibiotics (avoid 3 days before/after)
  • Mefloquine (separate by 12h)
  • Immunosuppressives

Reference: BNF; UKHSA Green Book Ch.33; https://bnf.nice.org.uk/drugs/typhoid-vaccine-live/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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