What are the CDC 2022 recommendations for cholera vaccine use?
Cholera is a bacterial infection that causes severe watery diarrhea and can lead to death within hours if fluids are not replaced. In the United States, cholera is rare but can occur in travelers visiting countries with ongoing outbreaks. The CDC's Advisory Committee on Immunization Practices (ACIP) released specific guidance in 2022 on when to use the oral cholera vaccine for adults.
What the research says
The 2022 ACIP report summarizes recommendations for the use of the lyophilized CVD 103-HG R vaccine in the United States 4. This vaccine is derived from Vibrio cholerae O1 and is administered as a single dose 4. The committee previously published recommendations for adults aged 18 to 64 years and updated these guidelines in 2022 4.
The primary recommendation is for travelers who are at increased risk for poor outcomes from cholera 4. This includes individuals who cannot readily access medical services or have medical conditions that would be worsened by dehydration, such as cardiovascular or kidney disease 4. The vaccine is intended for use in travelers to countries where cholera is endemic or epidemic and associated with unsafe water and inadequate sanitation 4.
Research supports the use of oral cholera vaccination as a public health response to cholera outbreaks alongside water, sanitation, and hygiene interventions 1. A 2022-2023 outbreak in Malawi showed that reactive oral cholera vaccination reduced transmission by 53.5% to 62.1% 1. Field reports from Zimbabwe also underscore the importance of community-wide water, sanitation, and hygiene interventions, as well as vaccination, in reducing cholera's impact 2.
What to ask your doctor
- Am I at increased risk for severe cholera based on my medical history or travel plans?
- Do I have a condition like kidney disease or cardiovascular disease that makes dehydration dangerous?
- Is my destination considered to have unsafe water or inadequate sanitation?
- Is the oral cholera vaccine recommended for my specific travel itinerary?
- What are the signs of severe dehydration I should watch for while traveling?
This question is drawn from common patient questions about Infectious Disease and answered using cited medical research. We do not provide individualized advice.