CHEST INFECTION; CHEST INFECTION; TIREDNESS; HEADACHE; This spontaneous case report was received from a consumer (PVX2019-178) on 17-Jan-2019 and a follow-up information was received on 22-Jan-2019. The report describes a 54-year-old male consumer who had chest infection, tiredness, and headache following the intake of oral Vivotif (one dose every other day) for typhoid fever prophylaxis.  The consumer had a medical history of chest infection, chronic asthma, chronic bronchitis, blood pressure and sinus infection. He was a non-smoker and did not drink alcohol.  The consumer's concomitant medication included Azor (amlodipine and olmesartan; 5/20 mg) for blood pressure. He was taking Proventil spray (albuterol sulfate) and four Advils (ibuprofen) every four to eight hours to treat his sickness He also got a flu shot in the past.  It was reported that the consumer had a mean chest infection going on right now before taking Vivotif and was given treatment with steroids for his sickness before starting Vivotif. He was getting better, but then he got sick again while he took two doses of Vivotif. He reported that he was hacking up green phlegm that was green as grass and had a coughing fit last night. He stated that if he had a chest cold, then it was breaking up and getting better. He reported that he was tired, and his chest was congested. He was not sure if he had a chest cold or something else. He stated that he was also wheezing and at night, it gets worse. He reported that he also a had kind a headache.   The physician prescribed him a 5 days course of Z-Pak. He would be starting Vivotif again on Thursday or Friday waiting the three days between his antibiotic and starting Vivotif.  The action taken with Vivotif with respect to the events chest infection, tiredness, and headache was drug discontinued.  The clinical outcome of the events chest infection, tiredness, and headache was resolving.  Company's Comment: In this case a 54-year-old male consumer experienced chest infection, tiredness, and headache following the intake of oral Vivotif. There seems to be a temporal association between the intake of the vaccine and the event chest infection. However, the event chest infection is an infectious condition with commonly viral or bacterial etiology and the consumer has past history of chest infection, chronic asthma, chronic bronchitis. Hence, the causality of the event chest infection is assessed as unlikely with Vivotif vaccine. Also, the event tiredness and headache appear to be are due to the underlying chest infection. Hence, the causality of the event tiredness and headache is assessed as unlikely with Vivotif vaccine.; Sender's Comments: Company's Comment: In this case a 54-year-old male consumer experienced chest infection, tiredness, and headache following the intake of oral Vivotif. There seems to be a temporal association between the intake of the vaccine and the event chest infection. However, the event chest infection is an infectious condition with commonly viral or bacterial etiology and also the consumer has past history of chest infection, chronic asthma, chronic bronchitis. Hence, the causality of the event chest infection is assessed as unlikely with Vivotif vaccine. Also the event tiredness and headache appear to be are due to the underlying chest infection. Hence, the causality of the event tiredness and headache is assessed as unlikely with Vivotif vaccine.