The typhoid vaccine is not required for international travel. The typhoid vaccine should be used only by people traveling to high-risk areas who will be:
There are two forms of the typhoid vaccine that are available in the United States; each one is most effective when given at a particular age. Although the vaccines are both fairly effective in preventing typhoid (ranging from 50 percent to 80 percent), you should still heed the warning "boil it, peel it or forget it."
Typhoid is caused by a bacterium (Salmonella typhi) that attacks the intestines, causing fever, stomach pain and rash. Typhoid infection can result in shock, and possibly even death. Typhoid is common in developing countries where many sewage systems are substandard.
Typhoid infections are common in Mexico, East and South Asia (including India and Pakistan), South America and Africa. An estimated 22 million cases and 200,000 to 600,000 deaths occur worldwide each year.
Typhoid bacteria are ingested in contaminated food or water. They can be avoided by drinking only bottled water, and avoiding ice, unpeeled fruits, undercooked meats, shellfish, salads, or food from street vendors.
The typhoid vaccine comes in two forms:
The typhoid vaccine is not required for international travel. And the vaccine is not generally recommended for people traveling to areas where the infection is common. However, the typhoid vaccine is recommended for people who travel to high-risk areas if they plan on doing any of the following:
The typhoid vaccine should not be given to anyone less than 2 years of age.
Both the "Ty21a" and "polysaccharide" vaccines can cause headache and fever, but do not cause serious side effects.
The risk of catching typhoid fever is like the risk of catching cholera — it can be virtually eliminated by paying attention to the foods that you eat and the water that you drink. Although the disease is highly prevalent and occasionally deadly, it can be prevented by avoiding non-bottled water, ice, uncooked meats, salads, unpeeled fruits, shellfish and foods from street vendors. So, for most people, the typhoid vaccine is not necessary.
However, for people who travel in small towns or rural areas, are staying in areas without standard tourist accommodations, or who choose to eat foods likely to be contaminated with the bacteria, the benefits of the vaccine do outweigh the risks.
|A subset of international travelers|
|Disease Risks||Vaccine Risks|
Plotkin SA, Orenstein W, and Offit PA. Typhoid fever vaccines in Vaccines, 6th Edition, 2012, 812-836.
Reviewed by: Paul A. Offit, MD
Date: April 2013
Materials in this section are updated as new information becomes available. The Vaccine Education Center staff regularly reviews materials for accuracy.
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