Cholera Vaccine
Mechanism :
Cholera Vaccine is a sterile suspension of equal parts of Ogawa and Inaba serotypes of killed Vibrio cholerae in buffered sodium chloride injection. The Inaba and Ogawa strains of V. cholerae are grown on trypticase soy agar medium, removed from the medium with buffered sodium chloride injection and killed by the addition of 0.5 percent phenol. Phenol in a concentration of 0.5 percent is also used as the preservative in the finished vaccine. The vaccine contains 8 units of each serotype antigen (Ogawa and Inaba) per millilitre. Cholera vaccine may be injected intracutaneously (intradermally), subcutaneously or intramuscularly.
Indication :
- Active immunization against cholera is indicated only for individuals traveling to or residing in countries where cholera is endemic or epidemic.
Contraindications :
Use of cholera vaccine should be postponed in the presence of any acute illness.
A history of severe systemic reaction or allergic response following a prior dose of cholera vaccine is a contraindication to further use.
Dosing :
Cholera vaccine is commonly given in 2 SC doses, as follows:
First dose:
0.5 mL (approx. 4000 million vibrio); second dose: 1 mL (approx. 8 000 million vibrio) 3 to 4 weeks after the first injection. A third (first booster) SC dose of 1 mL approximately 3 to 4 weeks after the second dose. May be advisable. When circumstances do not permit of an interval of 3 to 4 weeks between doses, the interval may be shortened to 7 days.
Adverse Effect :
Erythema, induration, pain, tenderness at the site of injection, malaise, headache, mild-to-moderate temperature elevations.
Interaction :
Yellow Fever Vaccine: Administration of cholera and yellow fever vaccines within three weeks of each other may result in decreased levels of antibody response to both vaccines as compared with administration at longer intervals. It is currently recommended that, when feasible, cholera and yellow fever vaccines should be administered at a minimal interval of three weeks, unless time constraints preclude this. If the vaccines cannot be administered at least three weeks apart, they should be given simultaneously.
Hepatic Dose :
No dosage adjustments are recommended.