II. Indications

  1. Prevention of Vibrio Cholera O1 in adults travelling to Cholera-affected areas
    1. Travelers visiting friends and relatives
    2. Health care personnel
    3. Cholera outbreak response workers
    4. Extended travel to Cholera affected areas

III. Preparations

  1. Lypholized CVD 103-HgR (Vaxchora, PaxVax)
    1. Single dose, live attenuated, oral Cholera Vaccine
    2. Only FDA approved Cholera Vaccine in U.S. (approved in 2016)
    3. Efficacy beyond 3 months is not known as of late 2017
    4. Avoid use of antibiotics in the 14 days preceding Cholera Vaccine
    5. Delay starting Chloroquine for at least 10 days after oral Cholera Vaccine
    6. Delay taking oral Typhoid Vaccine by at least 8 hours after oral Cholera Vaccine
    7. Likely safe in HIV Infection (but lower seroconversion rate)
    8. Like safe in pregnancy as no systemic absorption (however Vaccine is shed for 7 days)
  2. Killed Cholera Vaccine
    1. Older intradermal Vaccine, 0.2 ml IM given at time 0, 1-4 weeks and then every 6 months as needed
    2. Protection of 30-50% lasts only 6 months
    3. Safe in Human Immunodeficiency Virus (HIV)
      1. Immunization in HIV
    4. Do not use in pregnancy
      1. See Vaccination in Pregnancy

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