Feasibility of Mass Vaccination Campaign with Oral Cholera Vaccines in Response to an Outbreak in Guinea

Oral cholera vaccines are safe and effective, and in 2010 were added to WHO recommendations for cholera outbreak control. However, doubts about feasibility, timeliness, and acceptability by the population, and the fear of diverting resources from other preventive interventions, have discouraged their use during epidemics. We report on the first large-scale use of oral cholera vaccine as an outbreak control measure in Africa; this was also the first time Shanchol vaccine was used in Africa. We administered 312,650 doses of vaccine during two vaccination rounds in two coastal districts in Guinea. The feasibility, timeliness of implementation, and delivery cost were similar to those of other mass vaccination campaigns. The campaign was well accepted by the population, and high vaccination coverage was achieved despite the short time available for preparation, the two-dose schedule, the remote rural setting, and the highly mobile population. Oral cholera vaccines are a promising new tool in the arsenal of cholera control measures, alongside efforts to improve provision of safe water and sanitation and access to cholera treatment.