Since Vivotif® also stimulates immunity in the intestinal tract, can the oral vaccine be used in a patient who has had part of the intestine removed?
The efficacy of VIVOTIF® (Typhoid Vaccine Live Oral Ty21a) is based on the growth of Ty21a in the small intestine. This growth-induced immune response then induces both local and systemic immunity. If all of the intestine has been removed, no priming of the host may be expected. If the small intestine or the duodenum is still functioning, the priming of the host is still possible. Therefore, after removal of the full intestine, VIVOTIF® is contraindicated, as no priming may occur. If the small intestine or part is still available, VIVOTIF® may be used as priming of the host is still possible.
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