Typhoid and Influenza Vaccine Timing
Typhoid and influenza vaccines can be administered simultaneously or at any interval before or after each other, with no required waiting period between them.
Key Principle: Inactivated Vaccines Have No Timing Restrictions
- Both inactivated typhoid vaccine and influenza vaccine (IIV/RIV) can be given at the same visit or separated by any interval without interference with immune responses 1, 2
- Inactivated vaccines do not interfere with the immune response to other inactivated vaccines or to live vaccines, allowing completely flexible scheduling 1, 2
- Injectable vaccines given concomitantly should be administered at separate anatomical sites 1
Live Attenuated Vaccines: Special Considerations
Oral Typhoid (Ty21a) Vaccine
- Oral Ty21a typhoid vaccine can be administered simultaneously with or at any interval before or after influenza vaccines (both IIV and LAIV) 1
- Ty21a and parenteral live vaccines can be administered simultaneously or at any interval before or after each other if indicated 1
- The only antimalarial interaction to note: mefloquine should be separated from Ty21a by at least 24 hours to avoid potential immune interference 1
Live Attenuated Influenza Vaccine (LAIV)
- LAIV may be administered simultaneously with oral Ty21a typhoid vaccine or at any interval 1
- If LAIV is given with other parenteral live vaccines (not typhoid), they should either be administered on the same day or separated by at least 4 weeks 1, 2
- Oral typhoid vaccine and oral rotavirus vaccine can be administered simultaneously with or at any interval before or after LAIV 1
Practical Algorithm
For Inactivated Typhoid + Any Influenza Vaccine:
- Administer both at the same visit at different anatomical sites, OR
- Administer at any interval apart (no waiting period required) 1, 2
For Oral Ty21a Typhoid + Any Influenza Vaccine:
- Administer simultaneously or at any interval (no restrictions) 1
For LAIV + Oral Ty21a Typhoid:
- Administer simultaneously or at any interval (no restrictions) 1
Common Pitfalls to Avoid
- Do not unnecessarily delay either vaccine - there is no medical reason to separate typhoid and influenza vaccines, and delaying increases the risk of missing the optimal protection window 1
- Do not confuse oral Ty21a with injectable typhoid vaccine - both have no timing restrictions with influenza vaccines, but the formulations differ 1
- Do not mix vaccines in the same syringe - always use separate injection sites when giving multiple injectable vaccines 1, 2
- Remember that simultaneous administration increases vaccination completion rates - giving vaccines together when indicated improves overall immunization coverage 2, 3