Volume 97 Number 4_Suppl
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



The devastating 2010 cholera epidemic in Haiti prompted the government to introduce oral cholera vaccine (OCV) in two high-risk areas of Haiti. We evaluated the direct costs associated with the government’s first vaccine campaign implemented in August–September 2013. We analyzed data for major cost categories and assessed the efficiency of available campaign resources to vaccinate the target population. For a target population of 107,906 persons, campaign costs totaled $624,000 and 215,295 OCV doses were dispensed. The total vaccine and operational cost was $2.90 per dose; vaccine alone cost $1.85 per dose, vaccine delivery and administration $0.70 per dose, and vaccine storage and transport $0.35 per dose. Resources were greater than needed—our analyses suggested that approximately 2.5–6 times as many persons could have been vaccinated during this campaign without increasing the resources allocated for vaccine delivery and administration. These results can inform future OCV campaigns in Haiti.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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  1. Ministere de la Sante Publique et de la Population, 2016. Rapport Cholera du jour par Department. Available at: http://mspp.gouv.ht/site/downloads/Rapport%20cholera%20revise%201er%20decembre%202016.pdf. Accessed December 14, 2016.
  2. Ministry of Public Health and Population, 2013. National Plan for the Elimination of Cholera in Haiti 2013–2022. Available at: http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=20326&Itemid=270&lang=en. Accessed July 22, 2014.
  3. Sur D, ., 2011. Efficacy of a low-cost, inactivated whole-cell oral cholera vaccine: results from 3 years of follow-up of a randomized, controlled trial. PLoS Negl Trop Dis 5: e1289. [Google Scholar]
  4. Luquero FJ, ., 2014. Use of Vibrio cholerae vaccine in an outbreak in Guinea. N Engl J Med 370: 21112120. [Google Scholar]
  5. Wierzba TF, ., 2015. Effectiveness of an oral cholera vaccine campaign to prevent clinically-significant cholera in Odisha state, India. Vaccine 33: 24632469. [Google Scholar]
  6. Bhattacharya SK, ., 2013. Five-year efficacy of a bivalent killed whole-cell oral cholera vaccine in Kolkata, India: a cluster-randomized, double-blind, placebo-controlled trial. Lancet Infect Dis 13: 1011. [Google Scholar]
  7. Qadri F, ., 2016. Efficacy of a single-dose, inactivated oral cholera vaccine in Bangladesh. N Engl J Med 374: 17231732. [Google Scholar]
  8. Ivers LC, ., 2013. Use of oral cholera vaccine in Haiti: a rural demonstration project. Am J Trop Med Hyg 89: 617624. [Google Scholar]
  9. Rouzier V, ., 2013. Cholera vaccination in urban Haiti. Am J Trop Med Hyg 89: 671681. [Google Scholar]
  10. Barzilay EJ, Schaad N, Magloire R, Mung KS, Boncy J, Dahourou GA, Mintz ED, Steenland MW, Vertefeuille JF, Tappero JW, , 2013. Cholera surveillance during the Haiti epidemic—the first two years. N Engl J Med 368: 599609. [Google Scholar]
  11. CDC, 2012. SurvCost: Estimating the Cost of Surveillance. Atlanta, GA: CDC. Available at: https://www.cdc.gov/globalhealth/healthprotection/idsr/resources.html. Accessed August 2, 2017.
  12. Oral cholera vaccines in mass immunization campaigns: guidance for planning and use - Addendum. World Health Organization, 2010. ISBN 978 92 4 150043 2. http://www.who.int/cholera/vaccines/AddendumGuideVaccinationForShanchol050913.pdf. Accessed August 2, 2017.
  13. Tohme RA, ., 2015. Oral cholera vaccine coverage, barriers to vaccination, and adverse events following vaccination, Haiti, 2013. Emerg Infect Dis 21: 984991. [Google Scholar]
  14. Legros D, Paquet C, Perea W, Marty I, Mugisha NK, Royer H, Neira M, Ivanoff B, , 1999. Mass vaccination with a two-dose oral cholera vaccine in a refugee camp. Bull World Health Organ 77: 837842. [Google Scholar]
  15. Schaetti C, Weiss MG, Ali SM, Chaignat CL, Khatib AM, Reyburn R, Duintjer Tebbins RJ, Hutubessy R, , 2012. Costs of illness due to cholera, costs of immunization and cost-effectiveness of an oral cholera mass vaccination campaign in Zanzibar. PLoS Negl Trop Dis 6: e1844. [Google Scholar]
  16. Cavailler P, ., 2006. Feasibility of a mass vaccination campaign using a two-dose oral cholera vaccine in an urban cholera-endemic setting in Mozambique. Vaccine 24: 48904895. [Google Scholar]
  17. Khan IA, ., 2013. Coverage and cost of a large oral cholera vaccination program in a high-risk cholera endemic urban population in Dhaka, Bangladesh. Vaccine 31: 60586064. [Google Scholar]
  18. Kar SK, ., 2014. Mass vaccination with a new, less expensive oral cholera vaccine using public health infrastructure in India: the Odisha model. PLoS Negl Trop Dis 8: e2629. [Google Scholar]
  19. Severe K, Rouzier V, Anglade SB, Bertil C, Joseph P, Deroncelay A, Mabou MM, Wright PF, Guillaume FD, Pape JW, , 2016. Effectiveness of oral cholera vaccine in Haiti: 37-month follow-up. Am J Trop Med Hyg 94: 11361142. [Google Scholar]
  20. Farmer P, ., 2011. Meeting cholera’s challenge to Haiti and the world: a joint statement on cholera prevention and care. PLoS Negl Trop Dis 5: e1145. [Google Scholar]

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  • Received : 27 Dec 2016
  • Accepted : 06 Jul 2017
  • Published online : 18 Oct 2017

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