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Vivaxim in Children

February 17th, 2016
shutterstock_149911907 HEp A

Hepatitis A Virus

We have recently published world first research on the use of Vivaxim in children.

Vivaxim is the combined Hepatitis A and Typhoid vaccine. In Australia Vivaxim is licensed for persons over the age of 16.  The use of Vivaxim in children 2-16 years of age is considered “off label”.

Vivaxim is unusual for a vaccine in that it is supplied in a novel ‘mixing syringe’. This means the vaccine for Hepatitis A and the the vaccine for Typhoid are loaded in the syringe, but separated. Just before administration the two vaccines are mixed inside the syringe, and injected down the one needle. This means fewer needles for the same protection.

Vivaxim in children is thought to be safe, as each separate vaccine ( the one for for hepatitis A and the one for typhoid ) is licensed in Australia to be given from  2 years of age, but no-one has ever surveyed the users to find out.

What we did

We studied 425 episodes of Vivaxim in children at our Travel Medicine Alliance clinics across Australia.  Nurses rang the parents  3 days after vaccination and asked about side effects in their children.  Reactions to Vivaxim were compared with reported reactions to the separate vaccines.


No serious side effects were reported, and 26.8% did not experience any side effects.

The most common local reactions were sore arm (70.5%), redness (16.0%) and swelling (11.1%). Reports of local side effects from Vivaxim were significantly more common than those reported for the individual separate vaccines.

In the children who only received Vivaxim on that day (n = 236), the most common more general side effects were tiredness/lethargy/malaise (5.9%), headache (4.2%), fever (3.4%) and sore muscles and joints (3.4%). Fever was more common in children under 6 years of age. Less than 5% of children reported missing school, sport or other regular activities.

It is not entirely unexpected that the Vivaxim in children  results in a more sore arm compared to the individual vaccines, but this information helps parents decide whether the benefits of one less needle is worth it for their child.


Vivaxim in children aged 2–16 years is well tolerated, and an acceptable option for children who require vaccination against both hepatitis A and typhoid. Parents now have a little more information about the side effects of Vivaxim so that they can make a more informed decision about travel vaccine options for their children.

One Response to “Vivaxim in Children”

  1. Michael Crouch says:

    Thank you, very helpful. Confirms what we’ve anecdotally found to be the case in using Vivaxim in children. The higher incidence of local side effects is worth knowing about.

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