To determine the effect of oral adjuvant-assisted and parenteral vaccination, germ-free piglets were vaccinated orally with and without labile toxin adjuvant or parenterally and challenged with viable Helicobacter pylori. All prechallenge vaccination regimens induced anti-H. pylori antibodies and suppressed bacterial colonization, but no vaccination regime completely prevented infection. Parenteral vaccination given after infection had no effect on bacterial colonization. Lymphocytic gastritis was present in all piglets challenged with live bacteria regardless of vaccination status. Neutrophilic gastritis was present in vaccinated challenged piglets but not in infected, unvaccinated piglets. Gastritis was not present in uninfected control piglets regardless of vaccination status. In gnotobiotic piglets, vaccination suppresses but does not prevent infection by H. pylori, and parenteral vaccination does not cure infected piglets. Vaccination does not ameliorate gastritis due to H. pylori in piglets but does induce neutrophilic gastric inflammation in some infected piglets.