title: Considerations for oral cholera vaccine use during outbreak after earthquake in Haiti, 2010-2011.
abstract: Oral cholera vaccines (OCVs) have been recommended in cholera-endemic settings and preemptively during outbreaks and complex emergencies. However, experience and guidelines for reactive use after an outbreak has started are limited. In 2010, after over a century without epidemic cholera, an outbreak was reported in Haiti after an earthquake. As intensive nonvaccine cholera control measures were initiated, the feasibility of OCV use was considered. We reviewed OCV characteristics and recommendations for their use and assessed global vaccine availability and capacity to implement a vaccination campaign. Real-time modeling was conducted to estimate vaccine impact. Ultimately, cholera vaccination was not implemented because of limited vaccine availability, complex logistical and operational challenges of a multidose regimen, and obstacles to conducting a campaign in a setting with population displacement and civil unrest. Use of OCVs is an option for cholera control; guidelines for their appropriate use in epidemic and emergency settings are urgently needed.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. kdate@cdc.gov
authors.forename: Kashmira A
authors.initials: KA
authors.lastname: Date
authors.forename: Andrea
authors.initials: A
authors.lastname: Vicari
authors.forename: Terri B
authors.initials: TB
authors.lastname: Hyde
authors.forename: Eric
authors.initials: E
authors.lastname: Mintz
authors.forename: M Carolina
authors.initials: MC
authors.lastname: Danovaro-Holliday
authors.forename: Ariel
authors.initials: A
authors.lastname: Henry
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Tappero
authors.forename: Thierry H
authors.initials: TH
authors.lastname: Roels
authors.forename: Joseph
authors.initials: J
authors.lastname: Abrams
authors.forename: Brenton T
authors.initials: BT
authors.lastname: Burkholder
authors.forename: Cuauhtémoc
authors.initials: C
authors.lastname: Ruiz-Matus
authors.forename: Jon
authors.initials: J
authors.lastname: Andrus
authors.forename: Vance
authors.initials: V
authors.lastname: Dietz
mesh_terms: D000284:Administration, Oral; D002771:Cholera / Q000453:epidemiology* / Q000517:prevention & control*; D022121:Cholera Vaccines / Q000008:administration & dosage* / Q000600:supply & distribution; D004196:Disease Outbreaks; D055866:Earthquakes; D004630:Emergencies / Q000453:epidemiology; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D032541:Mass Vaccination
chemical_list: D022121:Cholera Vaccines
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