Cholera vaccine (inactivated, oral)

How it works

It stimulates production of mucosal and circulating antibodies against V. cholerae O1 and against the cholera toxin B subunit, reducing toxin binding to the gut epithelium.

Prescribing in practice

• It is taken with the supplied buffer solution to protect the antigen from gastric acid, and food and drink should be avoided for a period before and after each dose to ensure efficacy.
• A primary course of more than one dose is required, completed before travel, with booster dosing if protection is to be maintained.
• It is not a substitute for scrupulous food, water and hygiene precautions and offers no reliable protection against the O139 serogroup or other diarrhoeal pathogens.

Monitoring

No routine laboratory monitoring is needed; observe for hypersensitivity after administration as with any vaccine.

Counselling the patient

• Dissolve the dose in the buffer exactly as instructed and avoid eating or drinking around the time of each dose.
• Maintain strict food and water hygiene as the vaccine does not give complete protection.

Evidence & guidelines

Oral inactivated cholera vaccine is recommended for selected travellers in UK immunisation guidance based on demonstrated protective efficacy in field trials.