Abstract
BackgroundDespite 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.Methodology/Principal FindingsWe 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/SignificanceThe 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.
Highlights
Provision of safe water and proper sanitation are without doubt the long-term and only solution for cholera control [1,2]
Two safe and effective oral cholera vaccines are recommended by the World Health Organization for cholera prevention and control; 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 Medecins Sans Frontieres, organized the first mass vaccination campaign using a two-dose oral cholera vaccine (Shanchol) as an additional control measure to respond to an on-going nationwide epidemic
Summary
Provision of safe water and proper sanitation are without doubt the long-term and only solution for cholera control [1,2]. Controlling cholera globally is far from being achieved; the disease burden is increasing with large-scale outbreaks reported in the past several years, such as those in Haiti and Zimbabwe [3]. Current outbreak response interventions focus on case management and access to health care, as well as the immediate provision of safe water and hygiene promotion [1]. Oral cholera vaccines (OCV), which have the potential to reduce the number of cases and minimize the spread of disease [4,5], could be an important addition to the cholera response arsenal [1,6,7]. 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. We present the results of vaccination coverage, acceptability and surveillance of adverse events
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