Vivotif Side Effects: What to Expect and When to Call Your Doctor

Vivotif is one of the most widely used travel vaccines in the world — over 150 million doses have been administered globally. Its side effect profile is generally mild, and serious reactions are rare. That said, knowing what to expect before you start the series can help you prepare and recognize when something warrants a call to your doctor.

How Safe Is Vivotif?

Vivotif has an excellent safety record. More than 150 million doses have been marketed worldwide. During a period from 1991 to 1995 alone — when more than 60 million doses were administered — the adverse event reports were remarkably few: 45 cases of diarrhea, 42 of abdominal pain, 35 of nausea, 34 of fever, 26 of headache, 26 of skin rash, 18 of vomiting, and 13 of urticaria. That's a very low rate for 60 million doses.

Common Side Effects of Vivotif

The most frequently reported side effects are gastrointestinal in nature, which makes sense given that Vivotif works in the GI tract. These are generally mild and self-limiting:

Abdominal pain or cramping

Nausea (the only side effect shown to occur at a statistically higher rate in vaccinated vs. placebo groups in clinical trials)

Diarrhea

Vomiting

Headache

Low-grade fever

Skin rash

Urticaria (hives)

These typically resolve on their own within a day or two without treatment. Taking each dose ~1 hour before a meal (as directed) may help minimize GI discomfort.

Serious Side Effects: What to Watch For

Serious adverse reactions to Vivotif are rare. However, seek immediate medical attention if you experience:

Signs of anaphylaxis: Difficulty breathing, throat tightening, severe swelling of the face/lips/tongue, rapid heartbeat, dizziness, or collapse. One isolated case of nonfatal anaphylactic shock has been reported in global postmarketing data.

Severe or persistent diarrhea or vomiting: If you develop an acute GI illness during the dosing series, stop taking Vivotif and contact your doctor. The vaccine should not be taken during active GI illness.

High fever: A mild, low-grade fever may occur, but a high fever (above 103°F / 39.4°C) warrants evaluation.

Severe skin reactions: Significant rash spreading beyond the trunk or extremities, or blistering, should be evaluated.

When Should You NOT Take a Vivotif Dose?

Skip or delay your current dose and call your doctor if you:

Are currently running a fever

Have started an antibiotic or sulfonamide since receiving your prescription

Have active diarrhea or vomiting that won't stop

Have accidentally left the capsules out of the refrigerator for an extended period

Cold Storage Note: A Practical Side Effect Trigger

One often-overlooked factor: taking a warm Vivotif capsule can impair its effectiveness and may affect tolerability. The capsule should be removed from the refrigerator only immediately before taking — do not let it warm to room temperature. Take it with a cold or lukewarm drink, not hot.

Reporting Adverse Events

Any serious adverse reaction to Vivotif should be reported to your healthcare provider and to the FDA's Vaccine Adverse Event Reporting System (VAERS) at vaers.hhs.gov.

Need more general info about Vivotif? See our guide on what Vivotif is, its uses, and dosage. And if you need help finding it in stock, medfinder can call pharmacies near you.