Mechanism of effect
Vaccine contains live attenuated cholera bacteria that replicate in the gastrointestinal tract of the recipient to provide immunity
Pharmacodynamic
Vibrio cholerae CVD 103-HgR strain live antigen is indicated for active oral immunization against infection caused by Vibrio cholerae serogroup O1 in patients between 18 and 64 years of age
Drug indications
- Cholera Prevention
Indicated for active immunization against disease caused by Vibrio cholerae serogroup O1 in adults aged 18-64 yr traveling to cholera-affected areas
Dosage
- 100 mL PO as a single dose a minimum of 10 days before potential exposure to cholera
Drug contraindications
Severe allergic reactionsHistory of severe allergic reaction (eg, anaphylaxis) to any vaccine ingredient or to a previous dose of any cholera vaccine
Side effects
Headache , tiredness , Abdominal painheadache
tiredness
nausea/vomiting
abdominal pain
Decreased appetiteInteractions
Cefadroxil , Delafloxacin , dicloxacillin , Cefamandole , Secnidazole , Plazomicin , Telavancin , ampicillin , Amikacin , Erythromycin , Streptomycin , Ofloxacin , Imipenem , dalbavancin , ertapenem , oritavancin , solithromycin , sulfanilamide , Siponimod , Methenamine , quinupristin and dalfopristin , nafcillin , ozanimod , Fidaxomicin , tedizolid , Dupilumab , Tildrakizumab , Guselkumab , Brodalumab , SULFISOXAZOLE , Cefdinir , Ceftaroline , Cefoxitin , Cefotetan , Aztreonam , Ibrutinib , Neomycin , Tigecycline , Demeclocycline , Colistin , Cefpodoxime , Cefditoren pivoxil , Daptomycin , Sarilumab , Tobramycin , Bacitracin , Mechlorethamine , Lincomycin , Ticarcillin , Vancomycin , Linezolid , Trimethoprim , cefepime , Oxacillin , Hydroxy urea , Clarithromycin , Chloramphenicol , Clindamycin , fosfomycin , Rifaximin , Levofloxacin , Minocycline , Meropenem , Melphalan , Moxifloxacin , Nitrofurantoin , Ceftriaxone , Cefotaxime , Cefuroxime , Sulfadiazine , Ciprofloxacin , Lomustine , Tetracycline , Gemifloxacin , Gentamicin , Doxycycline , Cefazolin , Ceftazidime , Procarbazine , Polymyxin b sulfate , benzathine penicillin , Penicillin G , Penicillin V , Piperacillin , Ocrelizumab , bedaquiline , Sarecycline , Cefiderocol , BacampicillinAlerts
- Safety and effectiveness have not been established in immunocompromised persons
- Viral shedding may occur in the stool of recipients for at least 7 days; potential for transmission of the vaccine strain to nonvaccinated close contacts (eg, household contacts); caution when considering whether to administer to individuals with immunocompromised close contacts
- Because of potential transmission of vaccine strain, vaccinees should take precautions (i.e., thorough and frequent handwashing, especially after bowel movements and before preparing and handling food) for ≥14 days after vaccination
Points of recommendation
- Duration of protection conferred by the primary dose beyond the evaluated 3-month period is unknown
- There is no recommendation for use of booster doses at this time
- Effectiveness has not been established in persons living in cholera-affected areas
- Cholera vaccine has not been shown to protect against disease caused by V cholerae serogroup O139 or other non-O1 serogroups
-For oral administration only
-Instruct patients to avoid eating or drinking for 1 hr before or after oral ingestion
-Reconstitution should be completed within 15 minutes of removing the carton from the freezer (no need to thaw)
-Pour 100 mL of cold or room temperature (41ºF-72ºF; 5ºC-22ºC) purified bottled water into a clean, disposable cup; do not use tap water, nonpurified bottled water, other beverages, or other liquids
- Store buffer component and active component packets frozen at −13°F to 5°F (−25°C to −15°C)
Pregnancy level
Safe - has not been found to be teratogenicNot absorbed systemically following oral administration, and maternal use is not expected to result in fetal exposure to the drug.
Maternal cholera disease is associated with adverse pregnancy outcomes, including fetal death.
Vaccine strain may be shed in the stool of the vaccinated mother for at least 7 days, with a potential for transmission from mother to infant during vaginal delivery.
Breast feeding warning
Not absorbed systemically by the mother following oral administration, and breastfeeding is not expected to result in exposure of the child
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