Typhoid and Hepatitis A Shots: Can You Get Them at the Same Time?

Short answer: yes. The typhoid injection and the hepatitis A vaccine are both non-live vaccines, and they can be given at the same appointment — one in each arm, or at least an inch apart in the same arm. There's no need to space them out, and giving them together doesn't make either one less effective or increase side effects. The oral typhoid vaccine can also be taken at any point before or after a hepatitis A injection.

The question people really need answered is usually the next one: how far before my trip do I need them? That's where the two vaccines differ, and where the oral typhoid option has a couple of catches worth knowing about.

Typhoid vs hepatitis A at a glance

They get bundled together because they're spread the same way — contaminated food and water — and are recommended for many of the same destinations. But they're very different vaccines.

Figures are from CDC. Canada's guidance differs slightly: boosters every 3 years for the injection and every 7 years for the capsules, with the capsules authorised from age 5. Your clinic will follow the local schedule.

Why getting them together is fine

The general rule in vaccination is that non-live vaccines can be given on the same day or at any interval before or after each other. Both the hepatitis A vaccine and the injectable typhoid vaccine fall into that category. CDC's guidance is that most vaccines can be given at the same visit, at separate injection sites, without weakening the immune response or increasing rates of side effects.

In practice, that's what most travel clinics do: hepatitis A in one arm, typhoid in the other, often alongside anything else you need (yellow fever, rabies, Japanese encephalitis, a tetanus booster) at the same visit.

The oral typhoid vaccine is live, but it's a live oral vaccine, and CDC lists it as safe to take simultaneously with, or at any interval around, other vaccines — including live injected vaccines like yellow fever or MMR.

Whatever happened to the combined shot?

If a friend told you they got hepatitis A and typhoid in a single injection, they're not misremembering — combined vaccines existed under the names Vivaxim, ViATIM and Hepatyrix. But they've largely disappeared:

• UK: Sanofi stopped producing ViATIM in December 2021 and UK supplies ran out in October 2022. UKHSA withdrew the related clinical protocol in 2024.
• Canada: The Canadian Immunization Guide now lists just two typhoid vaccines — the injection and the oral capsules — and Vivaxim's market status is listed as cancelled.
• US: A combined hepatitis A + typhoid vaccine was never licensed.

So for most travellers, expect two separate injections. That's not a downgrade — the separate vaccines protect against the same things.

One more source of confusion: Twinrix is hepatitis A + hepatitis B, not typhoid. If you've had Twinrix, you're covered for hepatitis A, but you still need a separate typhoid vaccine if it's recommended for your trip.

The oral typhoid catches

The oral vaccine (sold as Vivotif) appeals to people who'd rather skip a needle and want longer protection. But because it's made of live bacteria that need to survive in your gut, it comes with rules the injection doesn't:

• Antibiotics cancel it out. CDC advises waiting more than 72 hours after any antibiotic before starting the capsules, and not taking antibiotics within 72 hours of the last capsule. That matters if you're planning to use doxycycline — an antibiotic — as your antimalarial.
• Malarone timing. CDC recommends starting atovaquone-proguanil (Malarone) only once at least 10 days have passed since your final typhoid capsule, because of the proguanil component. (Canada's guidance treats the two as compatible, so your clinician may advise differently depending on where you are.) Mefloquine and chloroquine can be taken alongside it. See our antimalarials guide for how the options compare.
• All four capsules, on schedule, kept cold. One every other day, swallowed whole with a cool drink about an hour before a meal, stored in the fridge. Skip doses and you may not get full protection.
• Not for everyone. As a live vaccine, it shouldn't be used in pregnancy or by people with weakened immune systems — the injection is the alternative. Don't start it during a stomach bug.
• Alcohol. Avoid it for an hour before and two hours after each capsule, as it can damage the capsule's protective coating.
• Cholera vaccine. If you're also taking the oral cholera vaccine Dukoral, Canadian guidance is to separate the two by at least 8 hours.

None of this applies to the typhoid injection, which is why it's the simpler choice if you're short on time or already on antibiotics.

Leaving soon? What still works

If your trip is days away rather than weeks, here's how it plays out:

• Hepatitis A: Still get it. CDC's advice is that travellers should receive a dose before departure even when time is short, and more than 90% of people have protective antibody levels within a month of the first dose. If you're over 40, immunocompromised, or have chronic liver disease and are leaving within two weeks, your clinician may also offer an immune globulin shot for extra short-term cover.
• Typhoid injection: The standard advice is at least 2 weeks before travel, because that's when protection is expected to be in place. A dose given later may still be worth having for a longer trip, but you'll be less protected for the first part of it.
• Oral typhoid: The four capsules take a week to complete, and need to be finished at least a week before you're exposed. If you're flying in under two weeks, the injection is usually the more realistic option.

For the bigger picture on lead times, see how far in advance to see a travel doctor.

Where you'll be offered both

Typhoid and hepatitis A are recommended together for a large share of the world, including much of Latin America, Africa, and South and Southeast Asia. Typhoid risk is highest in South Asia — CDC notes that more than 70% of typhoid cases in US travellers are in people returning from South Asia, mainly Bangladesh, India and Pakistan — and travellers have caught it on trips of less than a week.

Advice on where typhoid vaccine is needed does vary by country. CDC recommends it for travellers to a wide range of regions, while Canada's guidance focuses on South Asia and treats other destinations, such as Africa, case by case — based on things like trip length, visiting friends and family, and travelling with children.

Our destination guides cover exactly what's recommended where, including India, Vietnam, Mexico, Thailand and Bali. Or check any country on the interactive vaccine map.

Vaccines aren't the whole story

Two important limits:

• Typhoid vaccines aren't 100% effective, and a large dose of bacteria can overwhelm the protection.
• Neither vaccine protects against paratyphoid fever, a closely related illness spread the same way, for which no vaccine exists.

So the vaccines work best alongside food and water precautions. Our guide to traveller's diarrhoea covers the practical rules and when to seek help.

Frequently asked questions

Can I get typhoid and hepatitis A vaccines on the same day as other travel vaccines?

Yes. Both can be given at the same visit as other common travel vaccines, including yellow fever, rabies, Japanese encephalitis and routine boosters, at separate injection sites.

Is there one shot that covers both typhoid and hepatitis A?

Combined vaccines (Vivaxim, ViATIM, Hepatyrix) used to exist, but they've been discontinued in the UK and Canada and were never licensed in the US. Most travellers now get two separate injections.

Does Twinrix protect against typhoid?

No. Twinrix combines hepatitis A and hepatitis B. You'd still need a separate typhoid vaccine.

Which is better, the typhoid injection or the oral capsules?

Both protect roughly 50–80% of people. The injection is one dose, works for ages 2 and up, and has no antibiotic or antimalarial interactions; it lasts about 2 years. The capsules last longer (about 5 years) and avoid a needle, but they're for ages 6 and up, need refrigeration and careful timing, and aren't suitable in pregnancy or for people with weakened immunity.

I had my first hepatitis A shot years ago and never got the second. Do I start again?

No. CDC guidance is that an interrupted hepatitis A series doesn't need to be restarted — you just get the next dose.

Do I need a booster for hepatitis A?

Not if you've completed the two-dose series. Boosters aren't recommended after that.

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Sources: CDC Yellow Book – Typhoid and Paratyphoid Fever · CDC Yellow Book – Hepatitis A · CDC Yellow Book – Vaccination and Immunoprophylaxis: General Principles · Public Health Agency of Canada – Canadian Immunization Guide: Typhoid vaccine · UKHSA – Hepatitis A/Typhoid vaccine PGD (withdrawn) · Health Product Shortages Canada – Vivaxim market status · Sanofi UK – ViATIM discontinuation · NaTHNaC TravelHealthPro – Typhoid fever

This article is for informational purposes only and does not constitute medical advice. Vaccine choice and timing depend on your health, medications and itinerary — always consult a qualified travel health professional or GP before travel.