Live attenuated Cholera Vaccine

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Shanchol vaccine oral cholera vaccine

The live Cholera vaccine is recommended for the prevention of cholera in high-risk patients. It provides active immunization against disease caused by Vibrio cholera serogroup O1 in adults 18 through 64 years of age.

Routine vaccination is recommended in the following group of patients according to the ACIP (Advisory Committee on Immunization Practices) guidelines:

  • Adult travelers aged 18 to 64 years from the US to an area of active cholera transmission.

The vaccine does not prevent the active disease and the efficacy has not been established in patients already living in the endemic areas with partial immunity.

It is different from the recombinant oral Cholera Vaccine (Dukoral).

Live Cholera vaccine dose in Cholera prevention:

    •  A single dose of 100 mL is administered 10 days or more prior to potential cholera exposure.

 

Not recommended for use in Children

 

Pregnancy Risk Factor C

The vaccine has not been studied in pregnant females. However, the vaccine is not absorbed systemically and fetal exposure is unlikely.

The neonate may be exposed to the vaccine following vaginal delivery as bacterial shedding may occur for a week or so following vaccination.

Maternal cholera may lead to dehydration and severe fatal adverse fetal outcomes.


Cholera vaccine use during breastfeeding:

Breastfeeding is compatible since the vaccine is not absorbed systemically.

 

The manufacturer has not recommended any dose adjustment in patients with renal disease.

 

The manufacturer has not recommended any dose adjustment in patients with liver disease.

 

Common side effects of Cholera vaccine:

  • Central nervous system

    • Fatigue
    • headache
  • Gastrointestinal

    • Abdominal pain
    • Nausea
    • Vomiting

Less common side effects of Cholera Vaccine:

  • Gastrointestinal

    • Diarrhea

 

Contraindication to the Live-attenuated Cholera Vaccine include:

  • Allergy to the vaccine or any component of the formulation or to a previous dose of any cholera vaccine

Warnings & Precautions

  • Anaphylactoid reactions may occur
  • Do not take the vaccine in acute illness
  • The ACIP (advisory committee on immunization practices recommends simultaneous administration of more than 1 vaccine on the same day at different anatomic sites of all age-appropriate vaccines (live or inactivated) for which a person is eligible at a single clinic visit [Ref].
  • Live vaccines should generally be avoided in immunocompromised patients. These include patients receiving chemotherapy or radiotherapy, steroids or other immunomodulators).
  • Live attenuated vaccines should not be administered for at least 3 months after immunosuppressive therapy when feasible.
  • Bacterial shedding in the stool may occur for 14 days or more after vaccination. The recipient should wash hands thoroughly after handling food and using the washroom.

 

Not applicable

 

How to take the live-attenuated Cholera Vaccine?

  • Do not eat or drink for 60 minutes before and after ingestion.
  • Administer the vaccine within 15 minutes of reconstitution.
  • Drink full contents of the cup at once
  • Discard any residue that may remain in a cup after consumption.

 

Mechanism of action of Live Cholera Vaccine: 

Cholera vaccine contains live attenuated cholera bacteria that replicate in the gastrointestinal tract of the recipient inducing host immunity.

Efficacy of live-attenuated cholera vaccine in one study was 90.3% and 79.5% at 10 days and 3 months post-vaccination respectively

The oral vaccine is not absorbed systemically and is excreted via feces

 

Live Cholera vaccine brand Names (Interantional):

  • Shanchol

 

Live Cholera vaccine Brand Name in Pakistan:

Cholera Vaccine [Inj 15 D]

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