Effectiveness of Oral Cholera Vaccine in Haiti: 37-Month Follow-Up

Karine Sévère Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes Centers, Port-au-Prince, Haiti; Center for Global Health, Department of Medicine, Weill Cornell Medical College, New York, New York; Division of Infectious Disease and International Health, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Ministry of Public Health and Population, Port-au-Prince, Haiti

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Vanessa Rouzier Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes Centers, Port-au-Prince, Haiti; Center for Global Health, Department of Medicine, Weill Cornell Medical College, New York, New York; Division of Infectious Disease and International Health, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Ministry of Public Health and Population, Port-au-Prince, Haiti

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Stravinsky Benedict Anglade Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes Centers, Port-au-Prince, Haiti; Center for Global Health, Department of Medicine, Weill Cornell Medical College, New York, New York; Division of Infectious Disease and International Health, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Ministry of Public Health and Population, Port-au-Prince, Haiti

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Claudin Bertil Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes Centers, Port-au-Prince, Haiti; Center for Global Health, Department of Medicine, Weill Cornell Medical College, New York, New York; Division of Infectious Disease and International Health, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Ministry of Public Health and Population, Port-au-Prince, Haiti

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Patrice Joseph Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes Centers, Port-au-Prince, Haiti; Center for Global Health, Department of Medicine, Weill Cornell Medical College, New York, New York; Division of Infectious Disease and International Health, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Ministry of Public Health and Population, Port-au-Prince, Haiti

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Alexandra Deroncelay Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes Centers, Port-au-Prince, Haiti; Center for Global Health, Department of Medicine, Weill Cornell Medical College, New York, New York; Division of Infectious Disease and International Health, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Ministry of Public Health and Population, Port-au-Prince, Haiti

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Marie Marcelle Mabou Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes Centers, Port-au-Prince, Haiti; Center for Global Health, Department of Medicine, Weill Cornell Medical College, New York, New York; Division of Infectious Disease and International Health, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Ministry of Public Health and Population, Port-au-Prince, Haiti

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Peter F. Wright Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes Centers, Port-au-Prince, Haiti; Center for Global Health, Department of Medicine, Weill Cornell Medical College, New York, New York; Division of Infectious Disease and International Health, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Ministry of Public Health and Population, Port-au-Prince, Haiti

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Florence Duperval Guillaume Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes Centers, Port-au-Prince, Haiti; Center for Global Health, Department of Medicine, Weill Cornell Medical College, New York, New York; Division of Infectious Disease and International Health, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Ministry of Public Health and Population, Port-au-Prince, Haiti

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Jean William Pape Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes Centers, Port-au-Prince, Haiti; Center for Global Health, Department of Medicine, Weill Cornell Medical College, New York, New York; Division of Infectious Disease and International Health, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Ministry of Public Health and Population, Port-au-Prince, Haiti

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The first oral cholera vaccine (OCV) campaign, since its prequalification by the World Health Organization, in response to an ongoing cholera epidemic (reactive vaccination) was successfully conducted in a poor urban slum of approximately 70,000 inhabitants in Port-au-Prince, Haiti, in 2012. Vaccine coverage was 75% of the target population. This report documents the impact of OCV in reducing the number of culture-confirmed cases of cholera admitted to the Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) cholera treatment center from that community in the 37 months postvaccination (April 2012–April 30, 2015). Of 1,788 patients with culture-confirmed cholera, 1,770 (99%) were either from outside the vaccine area (1,400 cases) or from the vaccinated community who had not received OCV (370 cases). Of the 388 people from the catchment area who developed culture-confirmed cholera, 370 occurred among the 17,643 people who had not been vaccinated (2.1%) and the remaining 18 occurred among the 52,357 people (0.034%) who had been vaccinated (P < 0.001), for an efficacy that approximates 97.5%. Despite not being designed as a randomized control trial, the very high efficacy is a strong evidence for the effectiveness of OCV as part of an integrated package for the control of cholera in outbreak settings.

Author Notes

* Address correspondence to Karine Sévère or Vanessa Rouzier, Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) Centers, 33 Boulevard Harry Truman, B.P. 15727, Port-au-Prince HT-6110, Haiti. E-mails: karinesevere@gheskio.org or vrouzier@gheskio.org

Financial support: This study was supported by United Nations Children's Fund (grant Renforcement et Maintien des Activités dans le Cadre de la Réponse pour le Choléra), the Centers for Disease Control and Prevention (5U2GGH000545-02), and the National Institutes of Health (5D43TW009606).

Authors' addresses: Karine Sévère, Vanessa Rouzier, Stravinsky Benedict Anglade, Claudin Bertil, Patrice Joseph, Alexandra Deroncelay, and Marie Marcelle Mabou, Les Centres GHESKIO (Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes), Port-au-Prince, Haiti, E-mails: karinesevere@gheskio.org, vrouzier@gheskio.org, vegatch@hotmail.com, claudinbert1902@gmail.com, pjoseph@gheskio.org, minister@mspp.gouv.ht, and mmabou@gheskio.org. Peter F. Wright, Department of Pediatrics, Dartmouth Medical School, Hanover, NH, E-mail: peter.f.wright@dartmouth.edu. Florence Duperval Guillaume, Ministry of Public Health and Population, Port-au-Prince, Haiti. Jean William Pape, Les Centres GHESKIO (Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes), Port-au-Prince, Haiti, and Center for Global Health, Department of Medicine, Weill Cornell Medical College, New York, NY, E-mail: jwpape@gheskio.org.

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