TRAVEL VACCINATION CLINIC. SCOTTSDALE, AZ

Typhoid Vaccine in Arizona

Typhoid fever spreads through contaminated food and water in South Asia, Southeast Asia, and Africa. Two vaccine formulations are available. We help you choose the right one, time it correctly around your other medications, and get you protected before you board.

Call (480) 435-2774 Book Online

55 to 80% injectable efficacy . 2 formulations available . 2 weeks before travel

QUICK FACTS

Typhoid is a significant global health issue that affects millions of people each year, especially in regions with inadequate sanitation and water quality.

  • Typhoid fever is a potentially severe and occasionally life-threatening febrile disease acquired by consuming contaminated food or water.
  • It is especially prevalent in the Indian subcontinent and is also a risk throughout Asia, Africa and regions of South and Central America.
  • An injectable typhoid vaccine provides immunity for 2 years before requiring a booster.
  • An oral form of the typhoid vaccine is also available that provides up to 5 years of protection.

Typhoid Fever: Common, Preventable, and Increasingly Drug-Resistant

Typhoid fever is a bacterial infection caused by Salmonella enterica serotype Typhi. Unlike many travel illnesses, typhoid is not transmitted by mosquitoes. It spreads through the fecal-oral route: contaminated drinking water, ice made from tap water, raw produce washed with unclean water, or street food handled by someone who is infected.

The WHO estimates 9 million to 21 million cases of typhoid fever occur globally each year, causing approximately 110,000 to 130,000 deaths. South Asia carries the heaviest burden, accounting for the majority of cases worldwide. Southeast Asia and Sub-Saharan Africa follow as high-burden regions.

Typhoid presents as a prolonged fever with headache, fatigue, abdominal pain, and either constipation or diarrhea. Without treatment it can progress to intestinal perforation, sepsis, and death. Antibiotic treatment is effective in most cases, but drug resistance is a growing and serious problem. Extensively drug-resistant (XDR) Salmonella Typhi has been circulating in Pakistan since 2016 and is resistant to all first-line and most second-line antibiotics. Typhoid vaccination remains the most reliable layer of protection regardless of local resistance patterns.

Who Should Get the Typhoid Vaccine

CDC recommends typhoid vaccination for travelers who meet any of the following criteria:

  • Traveling to South Asia, Southeast Asia, Sub-Saharan Africa, or other regions where typhoid is endemic
  • Visiting friends and relatives in high-risk countries, where exposure through home-cooked food and local water is more likely than at tourist hotels
  • Traveling to any destination where food and water safety cannot be reliably assured
  • Traveling for extended periods or to rural and off-the-beaten-path destinations in endemic regions
  • Working in healthcare, fieldwork, or humanitarian roles in endemic countries
  • Travelers with reduced or absent stomach acid (proton pump inhibitors, antacids, prior gastrectomy), which lowers the natural barrier to infection

Medically Reviewed By

Norman J. Bizon, PA-C, CTH
Medical Director, 30+ years clinical experience

Tessa E. McFall, ASN, EMT
Travel Health Clinician

Last updated May 4, 2026

DESTINATIONS

Where Typhoid Is a Risk

Typhoid risk is linked to food and water safety infrastructure, not geography alone. Risk is highest in South Asia, where drug-resistant strains are increasingly common, and remains significant across Southeast Asia, Sub-Saharan Africa, and parts of Latin America.

India. The highest typhoid burden of any country globally. Risk is present in all regions including major cities. Travelers visiting friends and relatives face the highest exposure, but hotel-based tourists are not exempt. Drug-resistant strains including XDR Typhi are documented. Vaccination strongly recommended for all travelers.

Pakistan. Site of the ongoing XDR typhoid outbreak first detected in 2016. XDR strains are resistant to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, fluoroquinolones, and third-generation cephalosporins. Vaccination is the most reliable protection available. Strongly recommended for all travelers.

Bangladesh. Among the highest incidence rates in the region. Vaccination recommended for all travelers, including business travelers to Dhaka.

Nepal. High risk throughout the country, including Kathmandu. Trekkers eating at teahouses along popular routes face ongoing food and water exposure. Vaccination recommended for all travelers and strongly recommended for trekkers and long-stay visitors.

Sri Lanka. Moderate to high risk. Recommended for most itineraries outside of high-end resort environments. Risk is higher outside Colombo in rural areas.

Afghanistan. Very high risk. Limited sanitation infrastructure. Recommended for all travelers and humanitarian workers.

Cambodia. High endemic risk. Street food and local restaurant dining carry significant exposure. Recommended for all travelers.

Laos. High risk, particularly outside Vientiane. Recommended for all travelers including those on river itineraries.

Vietnam. Moderate to high risk. Risk is present even in popular tourist destinations like Hanoi and Ho Chi Minh City. Recommended for travelers who eat at local markets or street food stalls.

Myanmar. High risk throughout. Limited sanitation in rural areas. Recommended for all travelers.

Indonesia. Moderate to high risk. Bali carries lower risk than rural Java, Sulawesi, or Papua, but risk is not absent. Recommended for most itineraries, particularly those involving local food.

Philippines. Moderate risk in major cities, higher in rural and island areas. Recommended for travelers venturing outside major tourist resorts.

Thailand. Moderate risk. Risk is lower for travelers staying at international hotels and eating at vetted restaurants. Recommended for budget travelers, street food enthusiasts, and those visiting rural areas or the northern hill tribe regions.

East Africa (Kenya, Tanzania, Ethiopia, Uganda). Moderate risk in urban areas, higher risk in rural destinations and refugee settings. Recommended for safari travelers eating outside of high-end camps, long-stay volunteers, and those visiting local communities.

West Africa (Nigeria, Ghana, Senegal, Ivory Coast). Moderate to high risk throughout. Urban water infrastructure is unreliable in many cities. Recommended for all travelers.

Sub-Saharan Africa (general). Risk varies by country and setting. Generally recommended for travelers venturing beyond international hotels, particularly in countries with limited sanitation infrastructure.

Egypt and North Africa. Moderate risk outside resort areas. Recommended for travelers visiting local markets, eating street food, or traveling outside tourist corridors.

Latin America (Peru, Bolivia, Guatemala, El Salvador, Honduras). Moderate risk in rural and highland areas. Recommended for travelers to rural Peru, Bolivia, and Central American countries outside of resort zones.

Risk varies by destination, itinerary, and activities. We review current CDC guidance for your specific trip at your appointment.

SAFETY

Who Should Not Get Which Typhoid Vaccine

Typhoid vaccines come in two formulations with different safety profiles. Contraindications differ between the injectable and the oral vaccine. Knowing which applies to you determines which option is right for your trip.

Oral Vaccine (Ty21a / Vivotif) Contraindications

The oral typhoid vaccine is a live attenuated bacterial vaccine. Do not use it if you:

  • Are under 6 years of age
  • Are immunocompromised for any reason: HIV with low CD4 counts, active cancer therapy, organ transplant, primary immunodeficiency, or high-dose corticosteroids
  • Are currently taking antibiotics (must wait at least 24 hours after the last antibiotic dose before starting the series)
  • Are taking mefloquine or chloroquine for malaria prevention (complete the oral vaccine series at least 10 days before starting mefloquine or chloroquine)
  • Are pregnant (live vaccine. Injectable preferred if vaccination is necessary)
  • Have a known hypersensitivity to any component of the formulation

Injectable Vaccine (Vi Polysaccharide / Typhim Vi) Contraindications

The injectable vaccine is not a live vaccine and has a narrower contraindication list:

  • Children under 2 years of age
  • Previous severe allergic reaction (anaphylaxis) to this vaccine or any of its components
  • Active moderate or severe acute illness. Defer until recovered

For most immunocompromised travelers, the injectable vaccine is the appropriate choice. It is not a live vaccine and can be given safely to patients who cannot receive live vaccines.

Call to Discuss Your Case

SPECIAL CONSIDERATIONS

Situations We See Every Week

Injectable vs. Oral: Which Is Right for You

One injection is simpler and requires no refrigeration during travel. Four oral capsules taken on alternating days over a week last longer (5 years vs. 2 years) and suit frequent travelers to endemic regions. Drug interactions and immune status often decide the question. We walk through both options at your consultation.

Antibiotic and Antimalarial Interactions

Antibiotics kill the live bacteria in the oral vaccine and prevent it from working. Mefloquine and chloroquine also inhibit Ty21a. If you are taking any of these for prophylaxis or treatment, timing matters. Injectable typhoid avoids all of these interactions entirely. Bring your full medication list to your appointment.

Immunocompromised Travelers

Patients on biologics, disease-modifying antirheumatic drugs, cancer therapy, or post-transplant immunosuppression should receive the injectable Vi polysaccharide vaccine, not the oral live vaccine. The injectable is appropriate for most immunocompromised patients. Bring your medication list and any recent labs relevant to immune function.

Children

The injectable vaccine is approved for children 2 years and older. The oral vaccine is approved for children 6 years and older. Neither is recommended below those age thresholds. For young children traveling to high-risk destinations, we coordinate the injectable vaccine alongside the full pediatric travel medicine consultation.

Drug-Resistant Typhoid (XDR)

Extensively drug-resistant Typhi from Pakistan and parts of India is resistant to nearly all standard oral antibiotics. Azithromycin and carbapenems remain active, but XDR typhoid in a returning traveler is a difficult clinical situation. Vaccination is protective against XDR strains as well as susceptible ones. This makes pre-travel vaccination especially important for Pakistan travel.

Frequent Travelers and VFR Travelers

Travelers who visit family or friends in endemic countries face higher exposure than typical tourists: home-cooked food, local water, and longer stays in domestic settings. Oral typhoid (5-year protection) is often the better long-term choice for frequent travelers, provided no contraindications apply. We help you plan a sustainable multi-year vaccination schedule.

EFFECTIVENESS

Real-World Efficacy: What the Numbers Mean for Your Trip

The injectable Vi polysaccharide vaccine (Typhim Vi) achieves approximately 55 to 72 percent protective efficacy in field trials, with CDC citing a range of approximately 50 to 80 percent depending on the study population and duration of follow-up.

The oral Ty21a vaccine (Vivotif) achieves approximately 51 to 67 percent efficacy across meta-analyses, with some field trials reporting up to 76 percent protection over 3 years of follow-up. Efficacy declines as protection duration extends beyond the approved interval.

Neither vaccine eliminates risk entirely. Safe food and water practices remain essential throughout your trip, regardless of vaccination status. The vaccine adds a meaningful layer of protection. It does not replace behavioral precautions.

Protection begins approximately 2 weeks after the injectable dose and approximately 1 week after completing the oral series. Injectable protection lasts 2 years. Oral protection lasts 5 years. Booster dosing is recommended before return travel to endemic regions after those intervals.

55 to 72%

Injectable Efficacy
Vi polysaccharide field trials

51 to 67%

Oral Efficacy
Ty21a meta-analyses

2 years

Injectable protection duration

5 years

Oral protection duration

COST AND INSURANCE

What to Expect at Checkout

Travel vaccines are generally not covered by commercial health insurance, Medicare, or Medicaid because they are considered elective rather than medically necessary. That is an industry-wide pattern, not specific to TravelBug Health.

At Your Appointment

You will be charged for:

  • Travel health consultation (itinerary-based risk assessment)
  • The typhoid vaccine (injectable or oral formulation)
  • Any other vaccines or prescriptions you elect during the visit
  • Malaria prevention counseling and prescriptions if applicable

Pricing varies based on services. Call (480) 435-2774 for current pricing.

What to Ask Your Insurer

Before your appointment, call the member services number on your insurance card and ask:

  • Does my plan cover travel vaccines, including typhoid?
  • What CPT code do I submit? Injectable typhoid is typically 90691. Oral typhoid is typically 90690
  • Do I need pre-authorization?
  • Can I apply HSA or FSA funds?

For Reimbursement

After your appointment, we provide a detailed itemized receipt with:

  • CPT codes
  • Diagnosis codes
  • Clinician’s NPI
  • Itemized line items

Reimbursement outcome is between you and your insurer.

SAFETY PROFILE

Side Effects and Safety

Both typhoid vaccine formulations have well-established safety records. Side effect profiles differ between the injectable and oral options.

INJECTABLE. COMMON 7 TO 30%

Mild and Self-Limited

  • Soreness, redness, or swelling at the injection site (most common, resolves within 1 to 3 days)
  • Low-grade fever in approximately 1 percent of recipients
  • Headache and malaise in approximately 3 percent of recipients
  • Nausea or abdominal discomfort (uncommon)

ORAL. COMMON 5 TO 10%

Gastrointestinal and Mild Systemic

  • Nausea, abdominal cramping, or loose stools during the dosing week (typically mild and brief)
  • Low-grade fever and headache
  • Rash or urticaria (uncommon)
  • Vomiting (uncommon. If vomiting occurs within 30 minutes of a dose, that dose should be repeated)

BOTH FORMULATIONS. RARE

Serious Reactions

Anaphylaxis is rare but possible with either formulation. We observe all patients for 15 minutes after the injectable dose. Severe allergic reactions to the oral capsule are extremely uncommon.

There are no serious neurologic or viscerotropic adverse events associated with typhoid vaccines comparable to those rare events seen with the yellow fever vaccine.

Important for the oral vaccine: Capsules must be refrigerated and taken on a strict alternate-day schedule (days 1, 3, 5, and 7). Taking capsules on consecutive days, failing to refrigerate them, or taking them within 24 hours of an antibiotic dose will reduce or eliminate effectiveness. We review the dosing schedule in detail at your appointment.

WHAT HAPPENS NEXT

After Your Typhoid Vaccination

1

Complete the Course

If you chose the oral vaccine, all 4 capsules must be taken on alternate days and finished at least 1 week before arrival. Do not take antibiotics during the dosing week. Keep capsules refrigerated until each dose. Missing or misordering doses reduces protection.

2

Continue Food and Water Precautions

Typhoid vaccines are 55 to 80 percent protective, not 100 percent. Safe food and water practices remain essential throughout your trip: drink bottled or treated water, avoid ice made from tap water, eat cooked foods served hot, and peel your own fruit.

3

Know Your Booster Schedule

Injectable protection expires after 2 years. Oral protection expires after 5 years. If you return to an endemic region after those intervals, a booster is required. Keep a record of your vaccination date and the formulation you received so we can schedule your next dose accurately.

4

Coordinate Other Vaccines

Typhoid is rarely the only vaccine needed for South Asia or Southeast Asia. Hepatitis A, hepatitis B, Japanese encephalitis, rabies, and malaria prevention all depend on your destination, itinerary, and activities. We build the full picture at your consultation and coordinate timing to avoid interactions.

WHY A TRAVEL CLINIC

TravelBug vs. Primary Care or Pharmacy

Any licensed provider can administer typhoid vaccine. The difference is what surrounds the injection. Travel medicine expertise changes the quality and safety of the advice you receive alongside it.

TravelBug Health

  • Specialist-led itinerary-based risk consultation
  • Both injectable and oral formulations stocked and available
  • Drug interaction review for oral vaccine with antibiotics and antimalarials
  • Malaria prevention prescriptions and timing coordination
  • Hepatitis A, hepatitis B, and other travel vaccines same visit
  • Same-day or next-day appointments often available

PCP or Retail Pharmacy

  • Limited or general consultation only
  • Often injectable formulation only
  • Drug interactions with oral vaccine often missed
  • Limited malaria prevention coordination
  • May not stock full panel of travel vaccines
  • Variable scheduling

SCHEDULE YOUR VACCINATION

TravelBug Health in Scottsdale

We are a travel medicine clinic in the heart of the Phoenix metro. We see travelers from across the Valley and northern Arizona, and we have the scheduling flexibility and travel-medicine specialization that primary-care offices and retail pharmacies cannot match.

TravelBug Health Travel Clinic
8603 E Royal Palm Rd, Suite 120
Scottsdale, AZ 85258

Phone: (480) 435-2774
Email: team@travelbughealth.com
Hours: Monday to Friday, 9:00 AM to 5:00 PM (by appointment)

Call Now Book Online

Just minutes from across the Valley

North Scottsdale near the 101 and Shea Blvd:

No referral required. Same-day and next-day appointments are often available. Call us with your itinerary and we will find a time.

QUESTIONS TRAVELERS ASK

Frequently Asked Questions

Pricing varies based on your consultation and the services rendered. Call (480) 435-2774 for current pricing before your appointment. We are transparent about costs so there are no surprises. Travel vaccines are typically not covered by commercial insurance, Medicare, or Medicaid, though we provide detailed itemized receipts for HSA, FSA, or reimbursement claims.

The injectable typhoid vaccine (Vi polysaccharide, brand name Typhim Vi) is a single shot given at least 2 weeks before travel. It provides approximately 55 to 72 percent protection for 2 years. It is not a live vaccine, making it appropriate for immunocompromised travelers and those on antibiotics or antimalarials.

The oral typhoid vaccine (Ty21a, brand name Vivotif) consists of 4 capsules taken on alternating days (days 1, 3, 5, and 7), completed at least 1 week before travel. It provides approximately 51 to 67 percent protection for 5 years. It is a live vaccine and cannot be used by immunocompromised travelers or those taking certain antibiotics or antimalarials concurrently. It requires refrigeration.

We review both options at your consultation and help you choose based on your health history, medications, travel schedule, and frequency of travel.

Yes. CDC strongly recommends typhoid vaccination for all travelers to India. India has the highest typhoid burden of any country globally, with risk present in all regions including major cities. Drug-resistant strains including XDR Typhi are documented. This applies to tourists, business travelers, and travelers visiting friends and relatives. The vaccine should be completed at least 2 weeks before arrival.

Yes, and Pakistan carries particular urgency due to an ongoing extensively drug-resistant (XDR) typhoid outbreak that has been active since 2016. XDR Typhi is resistant to nearly all standard oral antibiotics, making it very difficult to treat. Vaccination is the most effective layer of protection available for travel to Pakistan. Strongly recommended for all travelers.

Typhoid vaccination is recommended for most travel to Southeast Asia, particularly Cambodia, Laos, Vietnam, Myanmar, and Indonesia. Risk is moderate in Thailand and lower in Singapore and Malaysia. The recommendation is stronger for travelers who will eat at street food stalls, local markets, or small restaurants, and for those staying outside of major international hotels. Tell us your specific itinerary and we will give you a precise recommendation.

No. The injectable vaccine is approximately 55 to 72 percent effective and the oral vaccine is approximately 51 to 67 percent effective. Neither eliminates the risk of typhoid. Safe food and water practices remain essential throughout your trip regardless of vaccination: drink bottled or treated water, avoid tap water ice, eat hot cooked foods, and peel your own fruit. The vaccine provides a meaningful additional layer of protection but does not replace behavioral precautions.

For the injectable vaccine, you need at least 2 weeks before arrival in the destination country for full protection to develop. For the oral vaccine, the 4-dose series must be completed at least 1 week before arrival. Since the oral series itself takes 7 days to complete, start it at least 2 weeks before departure to be safe. Ideally plan 4 to 6 weeks ahead so we can coordinate all recommended travel vaccines and medications without rushing.

No. Antibiotics kill the live attenuated bacteria in the oral vaccine and will prevent it from working. You must wait at least 24 hours after your last antibiotic dose before starting the oral series, and you should not take antibiotics during the 7-day dosing period. If you are currently on antibiotics or anticipate needing them around your travel preparation period, the injectable vaccine is usually the better choice. Bring your full medication list to your appointment so we can review this together.

It depends on the antimalarial. Mefloquine and chloroquine both inhibit the live bacteria in the oral typhoid vaccine and should not be taken concurrently. If you are taking mefloquine or chloroquine, complete the full oral typhoid series at least 10 days before starting those antimalarials. Atovaquone-proguanil (Malarone), doxycycline, and primaquine have different interactions that we review at your consultation. The injectable typhoid vaccine avoids all of these antimalarial timing concerns entirely.

Yes, but you must receive the injectable Vi polysaccharide vaccine, not the oral vaccine. The oral vaccine is a live bacteria and is contraindicated in immunocompromised individuals. The injectable vaccine is not live and is appropriate for patients with HIV, cancer, organ transplant, or those taking immunosuppressive medications. Bring a complete list of your conditions and medications to your appointment.

Yes. The injectable vaccine is approved for children 2 years and older. The oral vaccine is approved for children 6 years and older. For children traveling to high-risk destinations like India or South Asia who are too young for the oral formulation, the injectable vaccine is appropriate. We see pediatric travelers regularly and can coordinate typhoid alongside all other recommended travel vaccines for your child’s itinerary.

The injectable Vi polysaccharide vaccine provides protection for approximately 2 years. The oral Ty21a vaccine provides protection for approximately 5 years. A booster dose is recommended before returning to an endemic region after those intervals. Keep a record of your vaccination date and formulation. We track this at TravelBug Health and can remind you when a booster is due.

For the injectable vaccine, the most common side effects are soreness, redness, or swelling at the injection site. Fever, headache, and malaise occur in a small percentage of recipients and are mild and short-lived.

For the oral vaccine, some patients experience mild nausea, abdominal cramping, or loose stools during the dosing week. These are typically brief and resolve without treatment. Vomiting is uncommon, but if it occurs within 30 minutes of a dose, that dose should be repeated.

Serious allergic reactions (anaphylaxis) are rare with either formulation. We observe patients for 15 minutes after the injectable dose. There are no serious neurologic or organ adverse events associated with typhoid vaccines.

Most commercial health insurance plans, Medicare, and Medicaid do not cover travel vaccines including typhoid, as they are considered elective. Some plans offer partial reimbursement when you submit a claim with the appropriate CPT codes (90691 for injectable, 90690 for oral). HSA and FSA funds can generally be applied. We provide all required itemized receipts and documentation at your appointment.

Yes. The typhoid vaccine is 55 to 80 percent effective, which means a vaccinated traveler can still contract typhoid. Safe food and water practices remain important throughout your trip. Drink bottled or purified water, avoid ice in drinks at local establishments, eat foods that are cooked and served hot, avoid raw salads washed with local water, and peel your own fruit. Think of the vaccine as a safety net, not a free pass on food choices.

XDR stands for extensively drug-resistant. XDR Salmonella Typhi has been circulating in Pakistan since 2016 and is resistant to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, fluoroquinolones, and third-generation cephalosporins. This leaves very few treatment options for a traveler who contracts it. The good news is that typhoid vaccination is effective against XDR strains. Vaccination before traveling to Pakistan is particularly important for this reason.

  • A detailed travel itinerary (destinations, dates, planned activities)
  • Any prior immunization records
  • A current and complete medication list, including antibiotics, antimalarials, biologics, and immunosuppressants
  • Your insurance card if you plan to submit for reimbursement
  • Documentation of any prior severe allergic reactions to vaccines or medications

Yes. TravelBug Health is a travel medicine clinic in Scottsdale serving the entire Phoenix metro area. We carry both the injectable Vi polysaccharide vaccine and the oral Ty21a vaccine. Call (480) 435-2774 to schedule. Same-day and next-day appointments are often available.

Ready to Travel With Confidence?

Schedule Your Typhoid Vaccination

No referral required. Same-day and next-day appointments often available. We handle the consultation, help you choose the right formulation, review your medications for interactions, and coordinate your full travel vaccine panel. All in one visit.

Call (480) 435-2774 Book Online