Typhoid and Hepatitis A Vaccine (Vivaxim)

What is typhoid fever? 25% of adults with HA are hospitalized.  Typhoid fever is an infection caused by Salmonella Typhi bacteria. How is Typhoid Fever and  It is spread by eating or drinking food or Hepatitis A Prevented? water contaminated with human feces. It  Be very careful in selecting and handling food occurs often in areas where sanitation is and water. See the “Water and Food Safety for poor. International Travel” information sheet.  Transmission through sexual contact has  Immunization can reduce the risk. been documented rarely.  Practice good hand hygiene.  Symptoms include sudden fever, severe headache, tiredness, abdominal pain, How effective is the vaccine? nausea, loss of appetite, rose spots on the  This vaccine is 89% effective after 2 weeks trunk, a non-productive cough and and 90% effective after 4 weeks against constipation or diarrhea. typhoid fever.  If untreated, 10% of people with typhoid  This vaccine is 95% effective after 2 weeks fever can die. and 99% effective after 4 weeks against  Between 2-5% of people with typhoid fever Hepatitis A. become chronic carriers.  Vaccine may be less effective in people who are immunocompromised. What is Hepatitis A? How long does the protection last?  Hepatitis A (HA) is a virus that infects the liver.  Revaccination against typhoid fever is  HA is spread through the fecal-oral route: recommended every 3 years, if at continued By ingesting contaminated food or water risk. (e.g. food preparation by infected food handlers) From direct person-to-person contact  To provide long-term protection against From contamination of the environment or hepatitis A, a booster of hepatitis A vaccine objects (e.g. on counter tops or dishes) as the should be given 6 to 36 months later. HA virus may remain infectious in the environment for several weeks. What does the vaccine contain?  HA can be spread by sexual contact or through  Vivaxim contains inactivated S. typhi and sharing of equipment used for drug use. hepatitis A antigens, sodium chloride, disodium phosphate dihydrate, sodium  Symptoms usually last from 1-2 weeks, but may dihydrogen phosphate dihydrate, last for months and include fatigue, fever, loss of formaldehyde, 2-phenoxyethanol, appetite, nausea, jaundice (yellow colour of the aluminum, hydroxide, MRC-5 human diploid skin and whites of the eyes), dark-colour urine, cell, amino acids, mineral salts, polysorbate and light colour stools. 80, and neomycin.  Some infected persons may not develop any  Does not contain latex symptoms but can still spread the HA virus.

 Cases are infectious 2 weeks before they start Who should receive the vaccine? developing symptoms and for 1 week after  All travellers, 16 years or older, going to developing jaundice. South Asia.  For every 1,000 people infected, 1 to 3 could die. In adults > 50, 18 out of 1,000 cases can die.

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 Travellers, 16 years or older, to other Common (1% to 10 %) countries where a Typhoid risk exists  Fever, fatigue, nausea, diarrhea and especially if: dizziness  staying for more than 2 weeks Uncommon (< 0.1% to 1%)  eating adventurously  Skin itching and rash  visiting rural areas  visiting friends and relatives It is important to stay in the clinic for 15  children minutes after getting any vaccine because there  anatomic or functional asplenia is an extremely rare possibility of a life- (including individuals with Sickle Cell threatening allergic reaction called anaphylaxis. Disease) This may include hives, difficulty breathing, or  presence of low stomach acid, swelling of the throat, tongue or lips. If this gastrectomy, or use of acid reducing happens after you leave the clinic, call 911 or medication the local emergency number. This reaction can  vaccine is wanted for maximum be treated, and occurs in less than one in one protection. million people who get the vaccine.  People with ongoing household or intimate exposure to a chronic carrier of the bacteria Who should you report reactions to?  Laboratory workers who frequently handle  Report any adverse or unexpected reactions Salmonella typhi cultures. to your local public health nurse, doctor, nurse practitioner, or Healthline by calling Who should not receive the vaccine? 811 as soon as possible.  People under the age of 16 years.  For more information contact your local  Anyone who has had a life threatening Public Health Nurse at the number below. allergic reaction to a previous dose of Vivaxim or its components or a hepatitis A To ensure that a complete immunization record or typhoid vaccine containing one or more is maintained, every immunization administered of the same components. will be documented by Public Health into the electronic provincial immunization registry,  People with moderate to severe illness with known as Panorama. or without fever. Panorama is a secure electronic system used in  Pregnant women should discuss vaccination Saskatchewan to record and manage with their health care provider. immunization records and the health

information related to immunization for all How is the vaccine given? Saskatchewan residents.  By injection into a muscle. Immunization records may be shared with other

health care professionals to provide public When should the vaccine be given? health services; assist with diagnosis and  At least 2 weeks before travel to a risk area. treatment; and to control the spread of vaccine  May be safely given with other vaccines. preventable diseases. Information about Panorama is detailed in the What might be felt after receiving the vaccine? “Protecting the Privacy of Your Immunization Very Common (> 10%) Record” fact sheet.  Injection site tenderness pain, swelling, and redness; headache; muscle aches and weakness.

February 2019 DRAFT Page | 2 Specialty Immunization and Travel Health Centre 306-766-7904 http://www.rqhealth.ca/departments/travel-health-centre