title: First outbreak response using an oral cholera vaccine in Africa: vaccine coverage, acceptability and surveillance of adverse events, Guinea, 2012.
abstract: BACKGROUND
  Despite World Health Organization (WHO) prequalification of two safe and effective oral cholera vaccines (OCV), concerns about the acceptability, potential diversion of resources, cost and feasibility of implementing timely campaigns has discouraged their use. In 2012, the Ministry of Health of Guinea, with the support of Médecins Sans Frontières organized the first mass vaccination campaign using a two-dose OCV (Shanchol) as an additional control measure to respond to the on-going nationwide epidemic. Overall, 316,250 vaccines were delivered. Here, we present the results of vaccination coverage, acceptability and surveillance of adverse events.
  
  
  RESULTS
  We performed a cross-sectional cluster survey and implemented adverse event surveillance. The study population included individuals older than 12 months, eligible for vaccination, and residing in the areas targeted for vaccination (Forécariah and Boffa, Guinea). Data sources were household interviews with verification by vaccination card and notifications of adverse events from surveillance at vaccination posts and health centres. In total 5,248 people were included in the survey, 3,993 in Boffa and 1,255 in Forécariah. Overall, 89.4% [95%CI:86.4-91.8%] and 87.7% [95%CI:84.2-90.6%] were vaccinated during the first round and 79.8% [95%CI:75.6-83.4%] and 82.9% [95%CI:76.6-87.7%] during the second round in Boffa and Forécariah respectively. The two dose vaccine coverage (including card and oral reporting) was 75.8% [95%CI: 71.2-75.9%] in Boffa and 75.9% [95%CI: 69.8-80.9%] in Forécariah respectively. Vaccination coverage was higher in children. The main reason for non-vaccination was absence. No severe adverse events were notified.
  
  
  CONCLUSIONS
  The well-accepted mass vaccination campaign reached high coverage in a remote area with a mobile population. Although OCV should not be foreseen as the long-term solution for global cholera control, they should be integrated as an additional tool into the response.
authors.affiliation: Epicentre, Paris, France.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Luquero
authors.forename: Lise
authors.initials: L
authors.lastname: Grout
authors.forename: Iza
authors.initials: I
authors.lastname: Ciglenecki
authors.forename: Keita
authors.initials: K
authors.lastname: Sakoba
authors.forename: Bala
authors.initials: B
authors.lastname: Traore
authors.forename: Melat
authors.initials: M
authors.lastname: Heile
authors.forename: Alpha Amadou
authors.initials: AA
authors.lastname: Dialo
authors.forename: Christian
authors.initials: C
authors.lastname: Itama
authors.forename: Micaela
authors.initials: M
authors.lastname: Serafini
authors.forename: Dominique
authors.initials: D
authors.lastname: Legros
authors.forename: Rebecca F
authors.initials: RF
authors.lastname: Grais
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology* / Q000517:prevention & control*; D022121:Cholera Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology*; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000473:pathology; D062665:Epidemiological Monitoring; D005260:Female; D016701:Guinea / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D055815:Young Adult
chemical_list: D022121:Cholera Vaccines