Overview
Protects against typhoid fever caused by Salmonella typhi, transmitted through contaminated food and water.
Recommended for travellers to regions where typhoid is endemic, particularly the Indian subcontinent, South-East Asia, Africa, Central and South America. Especially important for travellers visiting friends and relatives, staying in rural areas, or eating outside major hotels and restaurants.
Vaccination Schedule
Standard schedule: Typhim Vi (injectable): single dose. Vivotif (oral): 3 capsules on alternate days (day 1, 3, 5).
Accelerated schedule: No accelerated schedule available. Typhim Vi provides protection from about 7 days after injection. Vivotif requires at least 7 days after the last capsule.
Route: Typhim Vi: intramuscular injection. Vivotif: oral capsules (swallowed whole with cold or lukewarm water, 1 hour before a meal).
Brands Available in Australia (TGA-Registered)
- Typhim Vi (Sanofi)
- Vivotif (Emergent BioSolutions (PaxVax))
Cost in Australia
Estimated cost: Typhim Vi: $45-$65 per dose. Vivotif: $55-$75 for the 3-capsule course.
Medicare/PBS: Not funded under NIP or PBS for travellers. Available on private prescription.
Efficacy & Duration
Efficacy: 50-80% protective efficacy depending on vaccine type
Typhim Vi provides approximately 55-72% protection for 2-3 years. Vivotif provides approximately 50-80% protection for 5-7 years depending on the study. Neither vaccine provides complete protection; food and water precautions remain essential.
Duration of protection: Typhim Vi: revaccinate every 3 years if ongoing risk. Vivotif: revaccinate every 3-5 years (Australian Immunisation Handbook recommends every 3 years for both).
Side Effects
| Side Effect | Frequency |
|---|---|
| Typhim Vi: injection site pain, redness | Very common (>50%) |
| Typhim Vi: headache, malaise, mild fever | Common (10-50%) |
| Vivotif: abdominal discomfort, nausea, diarrhoea | Common (10-50%) |
| Vivotif: fever, headache, rash | Uncommon (1-10%) |
Contraindications
- Severe allergic reaction to a previous dose or vaccine component
- Vivotif only: immunocompromised persons (live vaccine), concurrent antibiotic or antimalarial therapy (can inactivate the live vaccine), acute febrile illness, inflammatory bowel disease
- Vivotif: children under 6 years of age (unable to swallow capsules whole)
Special Populations
Pregnancy
Typhim Vi: Category B2. Can be given if clearly indicated. Vivotif: Category B2 but as a live vaccine, generally avoided in pregnancy unless risk of disease is high.
Children
Typhim Vi: licensed from 2 years of age. Vivotif: licensed from 6 years of age (child must be able to swallow capsules whole). No typhoid vaccine is licensed under 2 years.
Immunocompromised Travellers
Typhim Vi (injectable, inactivated): safe to administer to immunocompromised individuals, though immune response may be reduced. Vivotif (oral, live): contraindicated in immunocompromised persons including HIV with CD4 count below 200.
Frequently Asked Questions
Should I get the typhoid injection or the oral vaccine?
Both provide similar protection. The injection (Typhim Vi) is a single dose and suits most travellers. The oral vaccine (Vivotif) requires 3 capsules over 5 days but may suit those who prefer not to have an injection. Vivotif cannot be used by immunocompromised individuals or with certain antibiotics and antimalarials.
Do I need typhoid vaccine for India?
Yes, strongly recommended. The Indian subcontinent has the highest global incidence of typhoid fever. Vaccination is recommended for all travellers to India, even those staying in major cities or upmarket hotels.
How effective is the typhoid vaccine?
Typhoid vaccines provide 50-80% protection. This means you should still practise careful food and water hygiene. Drink bottled or boiled water, avoid ice, eat freshly cooked hot food, and peel fruit yourself.
How much does the typhoid vaccine cost?
The injectable vaccine (Typhim Vi) costs $45-$65. The oral vaccine (Vivotif) costs $55-$75 for the 3-capsule course. Neither is covered by Medicare for travellers. You will also pay a consultation fee.
How long does typhoid vaccination last?
Both typhoid vaccines require a booster every 3 years if you continue to travel to endemic areas. The oral vaccine may provide slightly longer protection (up to 5 years in some studies) but Australian guidelines recommend revaccination every 3 years for both.
Can I take antibiotics with the oral typhoid vaccine?
No. Antibiotics can kill the live bacteria in Vivotif and render it ineffective. Avoid antibiotics from 3 days before starting the course until 3 days after the last capsule. If you need antibiotics, use the injectable Typhim Vi instead.
Does the typhoid vaccine protect against all food poisoning?
No. Typhoid vaccine only protects against Salmonella typhi, one specific bacterium. It does not protect against traveller's diarrhoea, other Salmonella species, E. coli, cholera, or other foodborne illnesses. Safe food and water precautions are still essential.
Can children get the typhoid vaccine?
The injectable Typhim Vi can be given from 2 years of age. The oral Vivotif is licensed from 6 years because the child must be able to swallow capsules whole without chewing. No typhoid vaccine is available for children under 2 years.
Sources & References
Last updated: April 2026