Cholera Vaccination Guidelines

Determining Vaccination Indication

The Centers for Disease Control and Prevention recommends cholera vaccine for travelers to areas with active cholera transmission, defined as regions with current endemic or epidemic cholera or cholera activity within the past year prone to recurrence 1, 2
Active transmission means a province, state, or administrative subdivision with endemic or epidemic cholera caused by toxigenic V. cholerae O1, including areas with cholera activity within the past year that are prone to recurrence 1, 2

The American College of Physicians recommends CVD 103-HgR (Vaxchora) as a single oral dose for adults 18-64 years traveling to areas with active cholera transmission 4, 5
The vaccine is not approved for adults ≥65 years 1, 2

The Centers for Disease Control and Prevention recommends that travelers visiting friends and relatives, healthcare personnel working in affected areas, cholera outbreak response workers, and persons traveling to or living in cholera-affected areas for extended periods should strongly consider vaccination 1, 2
Individuals with blood type O, low gastric acidity, or certain medical conditions should also consider vaccination 1, 2

The vaccine is not a substitute for prevention measures, and all travelers must follow strict food and water precautions regardless of vaccination status 1, 2
Protection is documented for at least 3 months post-vaccination, but duration beyond 3 months is unknown 1, 2

Elderly and immunocompromised travelers require heightened education about diarrheal disease risk and strict adherence to food and water safety measures 5
Pregnant women have increased risk of complications with diarrheal disease and warrant specific attention to education about risk 5