This vaccine is used to help prevent typhoid fever. Typhoid fever is an infection that can be spread by eating contaminated food or drinking contaminated water.

This vaccine is recommended for people who are traveling to areas where the infection is common (such as Africa, Asia, Central/South America), those who are in close contact to someone with an ongoing typhoid infection, and those who work with the bacteria (Salmonella typhi) in a lab.

This vaccine contains live bacteria that have been weakened. It works by increasing the body's natural defense (immunity) against the bacteria.

Vaccines may not fully protect everyone who receives them.

Read all vaccine information available from your health care professional before taking the vaccine. If you have any questions, ask your health care professional.

Before taking each dose, inspect the foil blister pack to make sure it is completely sealed. Carefully open the blister pack and inspect the capsule to make sure it is not damaged. Consult your health care professional if the foil blister pack or capsule is damaged.

Take this medication by mouth without food as directed by your health care professional, usually every other day for 4 doses. Swallow the capsule whole with cold or barely warm liquid about 1 hour before a meal. Place the capsule in your mouth and swallow with the liquid right away. Do not chew, crush, or hold the capsule in your mouth.

Follow the dosing schedule closely for the vaccine to get the most benefit from it. To help you remember, mark your calendar with a reminder. You should complete your course of the vaccine at least 1 week before possible exposure to typhoid fever. The vaccine can be taken every 5 years thereafter if needed.

This vaccine should not be taken at the same time as other vaccines taken by mouth (such as cholera vaccine).

Nausea may occur. If this effect lasts or gets worse, tell your health care professional promptly.

Remember that this vaccine has been prescribed because your health care professional has judged that the benefit to you is greater than the risk of side effects. Many people using this vaccine do not have serious side effects.

A very serious allergic reaction to this vaccine is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact health care professional.

Contact the health care professional for medical advice about side effects. The following numbers do not provide medical advice, but in the US you may report side effects to the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967. In Canada, you may call the Vaccine Safety Section at Public Health Agency of Canada at 1-866-844-0018.

Before taking the typhoid vaccine, tell the health care professional if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your health care professional for more details.

Before taking this vaccine, tell your health care professional your medical history, especially of:

• current fever/illness
• current stomach problems (such as vomiting/diarrhea that doesn't stop)
• immune system disorders (such as due to HIV infection, certain cancers such as leukemia/lymphoma, cancer or radiation treatment)
• vaccination history (including previous reactions to any vaccines)

This vaccine is not recommended for use during pregnancy. Discuss the risks and benefits with your health care professional.

It is unknown if this vaccine passes into breast milk. Consult your health care professional before breastfeeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your health care professional. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this vaccine are:

• antibiotics (such as sulfamethoxazole)
• drugs that weaken the immune system (such as cyclosporine, tacrolimus, cancer chemotherapy, corticosteroids such as prednisone)

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669.

Do not share this vaccine with others.

Keep vaccine records for yourself and your children and provide them to the health care professionals to prevent unnecessary re-vaccinations.

It is important to take each dose of this vaccine as scheduled. If you miss a dose, ask your health care professional right away for a new dosing schedule. Do not double the dose to catch up.

Store in the refrigerator away from light and moisture. Do not freeze. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.