Cholera Vaccine Recommendations Issued by ACIP

Vibrio Cholerae, Cholera
Vibrio Cholerae, Cholera
Report provides new recommendations and guidance for vaccination providers and travelers about the use of lyophilized CVD 103-HgR (Vaxchora, PaxVax, Redwood City, California).

The Advisory Committee on Immunization Practice (ACIP) has adopted and published recommendations regarding the use of cholera vaccine. Currently, Vaxchora (cholera vaccine, live, oral; ParVax) is the only vaccine available in the US for active immunization against disease caused by Vibrio cholerae serogroup O1.

The recommendation states that US adults (aged 18–64 years) who travel to an area of active cholera transmission should receive the vaccine. The vaccine is not routinely recommended for travelers who are not visiting areas of active cholera transmission. 

The efficacy of Vaxchora was studied in a randomized, placebo-controlled human challenge study (n=197) of US volunteers aged 18-45 years old. Of the total volunteers, 68 Vaxchora recipients and 66 placebo recipients were challenged by oral ingestion of Vibrio cholerae

The efficacy of Vaxchora was 90% among those challenged 10 days post-vaccination, and 80% among those challenged 3 months post-vaccination. In addition, 2 studies to assess the immune system’s response to Vaxchora were conducted in adults aged 18-64. Among adults aged 18-45, 93% of Vaxchora recipients produced antibodies indicative of protection from cholera. Among adults aged 46-64, 90% produced antibodies indicative of protection from cholera.

As data on the safety and efficacy of booster doses of Vaxchora are unavailable, and the duration of protection conferred by the primary dose beyond 3 months is unknown, a recommendation on the use of booster doses cannot be made at this time. In addition, there is no available data on the safety and efficacy of the vaccine in children and adolescents <18 years of age or adults aged ≥65 years, in pregnant or breastfeeding women, or in immunocompromised populations.

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Wong KK, Burdette E, Mahon BE, Mintz ED, Ryan ET, Reingold AL. Recommendations of the Advisory Committee on Immunization Practices for use of cholera vaccine. MMWR Morb Mortal Wkly Rep. 2017;66:482-485. doi: 10.15585/mmwr.mm6618a6

This article originally appeared on MPR