What Is Vivotif? Uses, Dosage, and What You Need to Know in 2026

Vivotif is the brand name for typhoid vaccine live oral Ty21a — the only oral typhoid vaccine available in the United States. If you're planning travel to a region where typhoid fever is common, your doctor may recommend Vivotif as pre-travel protection. Here's everything you need to know about it in 2026.

What Is Vivotif?

Vivotif is a live attenuated (weakened) bacterial vaccine administered orally in capsule form. Each enteric-coated capsule contains 2–10 × 10⁹ colony-forming units (CFUs) of live, attenuated Salmonella typhi Ty21a — the bacteria that causes typhoid fever. The enteric coating protects the bacteria from stomach acid so they can survive to colonize the small intestine and stimulate an immune response.

Vivotif is currently marketed by Bavarian Nordic (acquired from Emergent BioSolutions in May 2023). Over 150 million doses have been distributed worldwide, making it one of the most extensively used travel vaccines in history.

Who Should Take Vivotif?

Vivotif is FDA-approved for adults and children ages 6 and older. The CDC and ACIP recommend typhoid vaccination (either Vivotif or Typhim Vi) for:

Travelers to areas with a recognized risk of exposure to Salmonella typhi (South Asia, sub-Saharan Africa, parts of Latin America and Southeast Asia)

Individuals with intimate household contact with a documented typhoid carrier (e.g., an S. typhi carrier living in your home)

Microbiology laboratory workers who frequently work with S. typhi cultures

Vivotif is NOT recommended as a routine vaccine for the general US population. Typhoid fever is rare in the US due to sanitation infrastructure. The vaccine is specifically for people at elevated risk.

How Do You Take Vivotif? The Full Dosing Schedule

Vivotif comes as a 4-capsule blister pack. The complete primary series is:

Day 1: Take capsule 1

Day 3: Take capsule 2

Day 5: Take capsule 3

Day 7: Take capsule 4

Each capsule must be swallowed whole (never chewed), approximately 1 hour before a meal, with a cold or lukewarm drink. Do not take with a hot drink — heat can damage the live bacteria. All 4 doses must be completed at least 1 week before potential exposure.

How Long Does Vivotif Protection Last?

Vivotif efficacy has been shown to persist for at least 5 years. A booster — a new full 4-capsule series — is recommended every 5 years for people with continued risk of typhoid exposure. There is no experience using Vivotif as a booster for those previously vaccinated with injectable typhoid vaccine.

What Vivotif Does NOT Protect Against

Vivotif protects only against Salmonella typhi. It does not protect against:

Salmonella paratyphi A or B (which cause paratyphoid fever)

Other Salmonella species (e.g., food poisoning strains)

Other bacteria that cause enteric disease (cholera, E. coli, Shigella, etc.)

Safe food and water practices are still essential even after vaccination.

Who Should NOT Take Vivotif?

Children under age 6

Immunocompromised individuals (HIV, cancer, immune-suppressing medications)

People with active fever at the time of dosing

People on antibiotics or sulfonamides

People with hypersensitivity to any vaccine component (including lactose or sucrose in the capsule)

How Much Does Vivotif Cost?

The average cash retail price for a 4-capsule pack of Vivotif is approximately $154–$168. With a GoodRx coupon, prices drop to around $116–$117. With SingleCare, as low as $111. There is no generic version. Many insurance plans do not cover Vivotif as it's considered a travel medicine product.

To learn how Vivotif works at the molecular level, see our guide on how Vivotif works. And when you're ready to find it in stock, medfinder can call local pharmacies on your behalf.