The Advisory Committee on Immunization Practices (ACIP) has issued guidance for use of an oral live-attenuated cholera vaccine.
Vaccine strain: CVD 103-HgR (Vaxchora, PaxVax), lyophilized
Effectiveness against severe choleric diarrhea (> 3 liters in 24 hours): 90% at 10 days and 80% at 3 months.
Indications - all of the following:
(1) adult 18 to 64 years
(2) travel to an area of active cholera transmission (epidemic or endemic toxigenic V. cholerae O1)
(3) no contraindications (severe allergy to component, etc)
(4) no oral or parenteral antibiotics in the preceding 14 days unless travel unavoidable
Precautions:
(1) The patient should follow safe food and water precautions.
(2) The patient should take proper sanitation and personal hygiene measures.
(3) The bacteria is shed in stool and can be transmitted to contacts including neonates and family members.
(4) Safety has not been established for pregnant women or immunocompromised patients.
