DO NOT INJECT INTRAVENOUSLY.
Cholera vaccine should not be administered intramuscularly to persons with thrombocytopenia or any coagulation disorder that would contraindicate intramuscular injection.
A separate, sterilized syringe and needle should be used for each patient to prevent transmission of hepatitis B virus and other infectious agents from one person to another.
Before delivering the dose intramuscularly or subcutaneously, aspirate to help avoid inadvertent injection into a blood vessel.
Before the injection of any biological, the physician should take all precautions known for prevention of allergic or other side reactions. This should include: a review of the patient's history regarding possible sensitivity; and a knowledge of the recent literature pertaining to the use of the biological concerned.
Epinephrine (1:1000) should be available for immediate use when this product is injected.
Some data suggest that administration of cholera and yellow fever vaccines within three weeks of each other may result in decreased levels of antibody response to both vaccines as compared with administration at longer intervals. However, there is no evidence that protection to either disease is diminished following simultaneous administration. 1 It is currently recommended that, when feasible, cholera and yellow fever vaccines should be administered at a minimal interval of three weeks, unless time constraints preclude this. If the vaccines cannot be administered at least three weeks apart, they should be given simultaneously. 2
Pregnancy Category C
Animal reproduction studies have not been conducted with cholera vaccine. It is also not known whether cholera vaccine can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. However, as with other inactivated bacterial vaccines, its use is not contraindicated during pregnancy unless the intended recipient has manifested significant systemic or allergic reaction following administration of prior doses. Use of cholera vaccine during pregnancy should be individualized to reflect actual need. 1,3