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Emergent’s vaccines help protect today’s global travelers.

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Preparing travelers for typhoid and cholera regions

Globally, as many as 21 million cases of typhoid fever and 2.9 million cases of cholera are still officially reported each year.1,2 Cholera cases may actually be even higher due to underreporting or misdiagnosis. 3

Raising awareness of risks and educating travelers on the importance and value of vaccinations are key parts of an efficient pretravel consult4:

  • Focus on disease prevalence in specific destinations
  • Emphasize the importance of travelers keeping themselves and those around them healthy
  • Review vaccination protocols and provide additional guidance on minimizing common risks such as:
    • Transportation hazards and personal injury
    • Foodborne and waterborne infections
    • Vector-borne disease
    • Respiratory tract infec­tions
    • Bloodborne and sexually transmitted infections
  • Provide Emergent educational materials and suggest other resources such as CDC materials and TravelHealthConnect.com
  • Share your appreciation for travel to help you connect with consumers

The pretravel consultation is your chance to educate travelers on potential health risks and how to mitigate them, so they can be protected during their journey.4

See more specific information about typhoid and cholera for your consults below:

Typhoid Where is it? Vaccine Consult kit

TYPHOID

Parsing the threat from typhoid

Both people who are actively ill with typhoid fever and people who are carriers of the bacteria that cause typhoid fever can spread the bacteria to other people. When someone consumes contaminated food or drink, the bacteria can multiply and spread into the bloodstream, causing typhoid fever.5

Typhoid fever can be a life-threatening disease. Symptoms of infection include persistent high fever, weakness, stomach pain, headache, diarrhea or constipation, cough, and loss of appetite. People who do not get treatment can continue to have fever for weeks or months. As many as 30% of people who do not get treatment die from complications of typhoid fever. Unfortunately, there are fewer antibiotic treatment options today as drug-resistant typhoid bacteria have become more common in many parts of the world.5

Please see Important Safety Information and full Prescribing Information

[Read more]

Where is typhoid found?

According to the CDC, typhoid fever is common in many regions of the world, including parts of East and South Asia (Pakistan, India, and Bangladesh), Africa, the Caribbean, and Central and South America. Typhoid fever is not common in the United States.5

Please see Important Safety Information and full Prescribing Information

[Read more]

VIVOTIF: More than 150 million doses marketed worldwide6

VIVOTIF (capsules) is indicated for immunization of adults and children greater than 6 years of age against disease caused by Salmonella Typhi. Routine typhoid vaccination is not recommended in the US. Selective immunization against typhoid fever is recommended for the following groups6:

  1. Travelers to areas in which there is a recognized risk of exposure to S. Typhi
  2. Persons with intimate exposure (e.g., household contact) to an S. Typhi carrier
  3. Laboratory workers who work with Salmonella typhi

Please see Important Safety Information and full Prescribing Information

[Read more]

A healthier return to global travel

Here are some considerations before recommending VIVOTIF to travelers4,5:

  • Age (VIVOTIF is indicated for immunization of adults and children greater than 6 years of age)
  • Travel dates (VIVOTIF should be administered at least 1 week before potential S. Typhi exposure)
  • Whether the destination country has active typhoid transmission
  • Whether the region/province/state within a country has active typhoid transmission
  • Type of travel (e.g., vacation, visiting family, medical mission)
  • Availability of medical care at destination

Please see Important Safety Information and full Prescribing Information.

[Read more]
Cholera Where is it? Vaccine Consult kit

CHOLERA

Nearly all cholera cases in the US were contracted during international travel7

Cholera is an acute, diarrheal illness caused by infection of the intestine with the toxigenic bacterium Vibrio cholerae serogroup O1 or O139. An estimated 2.9 million cases and 95,000 deaths occur each year around the world. The infection is often mild or without symptoms, but can be severe. Approximately 1 in 10 people who get sick with cholera will develop severe symptoms such as watery diarrhea, vomiting, and leg cramps. In these people, rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.2

Please see Important Safety Information and full Prescribing Information

[Read more]

Where is cholera found?

The cholera bacterium is usually found in water or in foods that have been contaminated by feces from a person infected with cholera bacteria. Cholera is most likely to occur and spread in places with inadequate water treatment, poor sanitation, and inadequate hygiene.2

Cholera bacteria can also live in the environment in brackish rivers and coastal waters. Shellfish eaten raw have been a source of infection. Rarely, people in the U.S. have contracted cholera after eating raw or undercooked shellfish from the Gulf of Mexico.2

Please see Important Safety Information and full Prescribing Information

[Read more]

Help protect travelers with VAXCHORA

VAXCHORA is a vaccine indicated for active immunization against disease caused by Vibrio cholerae serogroup O1 in persons 2 through 64 years of age traveling to cholera-affected areas.10

Limitations of Use: The effectiveness of VAXCHORA has not been established in persons living in cholera-affected areas. The effectiveness of VAXCHORA has not been established in persons who have pre-existing immunity due to previous exposure to V. cholerae or receipt of a cholera vaccine. VAXCHORA has not been shown to protect against disease caused by V. cholerae serogroup O139 or other non-O1 serogroups.10

Please see Important Safety Information and full Prescribing Information

[Read more]

A healthier return to global travel

Here are some considerations before recommending VAXCHORA to discuss with travelers8,10:

  • Age (VAXCHORA is indicated for persons 2 through 64 years of age)
  • Travel dates (VAXCHORA should be administered at least 10 days before potential cholera exposure)
  • Whether the destination country has active cholera transmission
  • Whether the region/province/state within a country has active cholera transmission
  • Number of cholera cases in the destination

Please see Important Safety Information and full Prescribing Information

[Read more]
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VIVOTIF and VAXCHORA are available through most wholesalers and distributors.

If you need help finding these vaccines, please get in touch with us.

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References:

1. Typhoid Fever and Paratyphoid Fever: Information for Healthcare Professionals. Centers for Disease Control and Prevention. Accessed January 24, 2022. https://www.cdc.gov/typhoid-fever/health-professional.html 2. Cholera: General Information. Centers for Disease Control and Prevention. Accessed January 24, 2022. https://www.cdc.gov/cholera/general/index.html 3. Learoyd T, Gaut R. Cholera: under diagnosis and differentiation from other diarrhoeal diseases. J Travel Med. 2018;25(suppl 1):46-51. https://doi.org/10.1093/jtm/tay017 4. Centers for Disease Control and Prevention. CDC Yellow Book 2020: Health Information for International Travel. New York: Oxford University Press; 2017. 5. Typhoid VIS. Centers for Disease Control and Prevention. Accessed January 24, 2022. https://www.cdc.gov/vaccines/hcp/vis/vis-statements/typhoid.html 6. VIVOTIF [package insert]. Redwood City, CA: Emergent Travel Health Inc.; 2020. 7. Cholera. Centers for Disease Control and Prevention. Accessed January 24, 2022. https://www.cdc.gov/cholera/usa/index.html 8. Angelo KM, Conners EE. Cholera Vaccine for Travelers. Centers for Disease Control and Prevention; 2019. Accessed January 24, 2022. https://emergency.cdc.gov/coca/ppt/2019/slides_020719_cholera_vaccine_for_travelers.pdf 9. Clinical Update. Centers for Disease Control and Prevention. Accessed January 4, 2022. https://wwwnc.cdc.gov/travel/news-announcements/cholera-vaccine-for-travelers 10. VAXCHORA [package insert]. Redwood City, CA: Emergent BioSolutions Inc. 2020. 11. Wong KK, Burdette E, Mahon BE, Mintz ED, Ryan ET, Reingold AL. Recommendations of the Advisory Committee on Immunization Practices for Use of Cholera Vaccine. MMWR Morb Mortal Wkly Rep. 2017;66(18):482-485. 12. Data on file. Emergent BioSolutions Inc.; 2022.


Important Safety Information

Indication and Usage

VIVOTIF is indicated for immunization of adults and children greater than 6 years of age against disease caused by Salmonella enterica serovar Typhi.

Routine typhoid vaccination is not recommended in the United States of America. Selective immunization against typhoid fever is recommended for the following groups: 1) travelers to areas in which there is a recognized risk of exposure to S. Typhi; 2) persons with intimate exposure (e.g., household contact) to an S. Typhi carrier; and 3) microbiology laboratorians who work frequently with S. Typhi. There is no evidence to support the use of typhoid vaccine to control common source outbreaks, disease following natural disasters, or in persons attending rural summer camps.

Not all recipients of VIVOTIF will be fully protected against typhoid fever. Vaccinated individuals should continue to take personal precautions against exposure to typhoid organisms. The vaccine will not afford protection against species of Salmonella other than Salmonella Typhi or other bacteria that cause enteric disease. The vaccine is not suitable for treatment of acute infections with S. Typhi.

Important Safety Information

VIVOTIF is contraindicated in patients with a hypersensitivity to any component of the vaccine or the enteric-coated capsule. The vaccine should not be administered to persons during an acute febrile illness. Safety of the vaccine has not been demonstrated in persons deficient in their ability to mount a humoral or cell-mediated immune response, due to either a congenital or acquired immunodeficient state including treatment with immunosuppressive or antimitotic drugs. The vaccine should not be administered to these persons regardless of benefits.

Acute Gastrointestinal Illness: VIVOTIF is not to be taken during an acute gastrointestinal illness. Postpone taking the vaccine if persistent diarrhea or vomiting occurs.

Concomitant Administration with Sulfonamides and Antibiotics: The vaccine should not be administered to individuals receiving sulfonamides and antibiotics since these agents may be active against the vaccine strain and prevent a sufficient degree of multiplication to occur in order to induce a protective immune response.

Diminished Immune Response: Unless a complete immunization schedule is followed, an optimum immune response may not be achieved. Not all recipients of VIVOTIF will be fully protected against typhoid fever.

Personal Precautions: Vaccinated individuals should continue to take personal precautions against exposure to typhoid organisms (i.e., travelers should take all necessary precautions to avoid contact or ingestion of potentially contaminated food or water).

Concomitant Administration with Anti-malarial Drugs: Several anti-malaria drugs, such as mefloquine, chloroquine and proguanil (not approved for use in US) possess anti-bacterial activity which may interfere with the immunogenicity of VIVOTIF. A study showed that mefloquine and chloroquine can be administered together with VIVOTIF. Proguanil should be administered only if 10 days or more have elapsed since the final dose of VIVOTIF was ingested.

Adverse Reactions: The most common adverse reactions in clinical trials were abdominal pain (6.4%), nausea (5.8%), headache (4.8%), fever (3.3%), diarrhea (2.9%), vomiting (1.5%) and skin rash (1.0%). Only the incidence of nausea occurred at a statistically higher frequency in the vaccinated group as compared to the placebo group.

VIV FULL HCP ISI 07/2020

Please see full Prescribing Information.

Important Safety Information

Indication and Usage

VAXCHORA is a vaccine indicated for active immunization against disease caused by Vibrio cholerae serogroup O1 in persons 2 through 64 years of age traveling to cholera‑affected areas.

Limitations of Use: The effectiveness of VAXCHORA has not been established in persons living in cholera-affected areas. The effectiveness of VAXCHORA has not been established in persons who have pre-existing immunity due to previous exposure to V. cholerae or receipt of a cholera vaccine. VAXCHORA has not been shown to protect against disease caused by V. cholerae serogroup O139 or other non-O1 serogroups.

Important Safety Information

VAXCHORA is contraindicated in persons who have a history of severe allergic reaction (e.g., anaphylaxis) to any ingredient of VAXCHORA or to a previous dose of any cholera vaccine.

Altered Immunocompetence: The safety and effectiveness of VAXCHORA have not been established in immunocompromised persons and the immunologic response to VAXCHORA may be diminished in immunocompromised individuals.

Shedding and Transmission: Because VAXCHORA may be shed in the stool of recipients for at least 7 days and the vaccine strain can potentially be transmitted to non‑vaccinated close contacts (e.g., household contacts), use caution when considering whether to administer VAXCHORA to individuals with immunocompromised close contacts.

Adverse Reactions: In adults 18-45 years old, the most common adverse reactions (incidence > 3%) were tiredness (31%), headache (29%), abdominal pain (19%), nausea/vomiting (18%), lack of appetite (17%) and diarrhea (4%).

The most common adverse reactions for children and adolescents (incidence ≥10%) were:

  • Cohort 1 – age 12-<18 years: headache (45%), tiredness (41%), abdominal pain (38%), lack of appetite (29%) and nausea (22%)
  • Cohort 2 – age 6-<12: tiredness (35%), abdominal pain (27%), headache (26%), lack of appetite (15%) and nausea (14%)
  • Cohort 3 – age 2-<6: tiredness (31%), lack of appetite (19%), and abdominal pain (17%)

Antibiotics: Avoid concomitant administration of VAXCHORA with oral systemic antibiotics since these agents may be active against the vaccine strain. Do not administer VAXCHORA to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.

Antimalarial Prophylaxis: Immune responses to VAXCHORA may be diminished when administered concomitantly with chloroquine. Administer VAXCHORA at least 10 days before beginning chloroquine.

Immunosuppressive Treatments: Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids, may reduce the immune response to VAXCHORA.

VAX FULL HCP ISI 01/2021

Please see full Prescribing Information.

VIVOTIF Important Safety Information
Indication and Usage

VIVOTIF is indicated for immunization of adults and children greater than 6 years of age against disease caused by Salmonella enterica serovar Typhi.


Important Safety Information

Indication and Usage

VIVOTIF is indicated for immunization of adults and children greater than 6 years of age against disease caused by Salmonella enterica serovar Typhi.

Routine typhoid vaccination is not recommended in the United States of America. Selective immunization against typhoid fever is recommended for the following groups: 1) travelers to areas in which there is a recognized risk of exposure to S. Typhi; 2) persons with intimate exposure (e.g., household contact) to an S. Typhi carrier; and 3) microbiology laboratorians who work frequently with S. Typhi. There is no evidence to support the use of typhoid vaccine to control common source outbreaks, disease following natural disasters, or in persons attending rural summer camps.

Not all recipients of VIVOTIF will be fully protected against typhoid fever. Vaccinated individuals should continue to take personal precautions against exposure to typhoid organisms. The vaccine will not afford protection against species of Salmonella other than Salmonella Typhi or other bacteria that cause enteric disease. The vaccine is not suitable for treatment of acute infections with S. Typhi.

Important Safety Information

VIVOTIF is contraindicated in patients with a hypersensitivity to any component of the vaccine or the enteric-coated capsule. The vaccine should not be administered to persons during an acute febrile illness. Safety of the vaccine has not been demonstrated in persons deficient in their ability to mount a humoral or cell-mediated immune response, due to either a congenital or acquired immunodeficient state including treatment with immunosuppressive or antimitotic drugs. The vaccine should not be administered to these persons regardless of benefits.

Acute Gastrointestinal Illness: VIVOTIF is not to be taken during an acute gastrointestinal illness. Postpone taking the vaccine if persistent diarrhea or vomiting occurs.

Concomitant Administration with Sulfonamides and Antibiotics: The vaccine should not be administered to individuals receiving sulfonamides and antibiotics since these agents may be active against the vaccine strain and prevent a sufficient degree of multiplication to occur in order to induce a protective immune response.

Diminished Immune Response: Unless a complete immunization schedule is followed, an optimum immune response may not be achieved. Not all recipients of VIVOTIF will be fully protected against typhoid fever.

Personal Precautions: Vaccinated individuals should continue to take personal precautions against exposure to typhoid organisms (i.e., travelers should take all necessary precautions to avoid contact or ingestion of potentially contaminated food or water).

Concomitant Administration with Anti-malarial Drugs: Several anti-malaria drugs, such as mefloquine, chloroquine and proguanil (not approved for use in US) possess anti-bacterial activity which may interfere with the immunogenicity of VIVOTIF. A study showed that mefloquine and chloroquine can be administered together with VIVOTIF. Proguanil should be administered only if 10 days or more have elapsed since the final dose of VIVOTIF was ingested.

Adverse Reactions: The most common adverse reactions in clinical trials were abdominal pain (6.4%), nausea (5.8%), headache (4.8%), fever (3.3%), diarrhea (2.9%), vomiting (1.5%) and skin rash (1.0%). Only the incidence of nausea occurred at a statistically higher frequency in the vaccinated group as compared to the placebo group.

VIV FULL HCP ISI 07/2020

Please see full Prescribing Information.

VAXCHORA Important Safety Information
Indication and Usage

VAXCHORA is a vaccine indicated for active immunization against disease caused by Vibrio cholerae serogroup O1 in persons 2 through 64 years of age traveling to cholera‑affected areas.

Important Safety Information

Indication and Usage

VAXCHORA is a vaccine indicated for active immunization against disease caused by Vibrio cholerae serogroup O1 in persons 2 through 64 years of age traveling to cholera‑affected areas.

Limitations of Use: The effectiveness of VAXCHORA has not been established in persons living in cholera-affected areas. The effectiveness of VAXCHORA has not been established in persons who have pre-existing immunity due to previous exposure to V. cholerae or receipt of a cholera vaccine. VAXCHORA has not been shown to protect against disease caused by V. cholerae serogroup O139 or other non-O1 serogroups.

Important Safety Information

VAXCHORA is contraindicated in persons who have a history of severe allergic reaction (e.g., anaphylaxis) to any ingredient of VAXCHORA or to a previous dose of any cholera vaccine.

Altered Immunocompetence: The safety and effectiveness of VAXCHORA have not been established in immunocompromised persons and the immunologic response to VAXCHORA may be diminished in immunocompromised individuals.

Shedding and Transmission: Because VAXCHORA may be shed in the stool of recipients for at least 7 days and the vaccine strain can potentially be transmitted to non‑vaccinated close contacts (e.g., household contacts), use caution when considering whether to administer VAXCHORA to individuals with immunocompromised close contacts.

Adverse Reactions: In adults 18-45 years old, the most common adverse reactions (incidence > 3%) were tiredness (31%), headache (29%), abdominal pain (19%), nausea/vomiting (18%), lack of appetite (17%) and diarrhea (4%).

The most common adverse reactions for children and adolescents (incidence ≥10%) were:

  • Cohort 1 – age 12-<18 years: headache (45%), tiredness (41%), abdominal pain (38%), lack of appetite (29%) and nausea (22%)
  • Cohort 2 – age 6-<12: tiredness (35%), abdominal pain (27%), headache (26%), lack of appetite (15%) and nausea (14%)
  • Cohort 3 – age 2-<6: tiredness (31%), lack of appetite (19%), and abdominal pain (17%)

Antibiotics: Avoid concomitant administration of VAXCHORA with oral systemic antibiotics since these agents may be active against the vaccine strain. Do not administer VAXCHORA to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.

Antimalarial Prophylaxis: Immune responses to VAXCHORA may be diminished when administered concomitantly with chloroquine. Administer VAXCHORA at least 10 days before beginning chloroquine.

Immunosuppressive Treatments: Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids, may reduce the immune response to VAXCHORA.

VAX FULL HCP ISI 01/2021

Please see full Prescribing Information.

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