Vaccine
Volume 34, Issue 1, 2016, Pages 128-133

Mass vaccination with a two-dose oral cholera vaccine in a long-standing refugee camp, Thailand (Article) (Open Access)

Phares C.R.* , Date K. , Travers P. , Déglise C. , Wongjindanon N. , Ortega L. , Bhuket P.R.N.
  • a Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop E03, Atlanta, GA 30329, United States, Thailand Ministry of Public Health, U.S. Centers for Disease Control and Prevention Collaboration, Ministry of Public Health, Tivanond Road, Nonthaburi, 11000, Thailand
  • b Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop A04, Atlanta, GA 30329, United States
  • c Première Urgence-Aide Médicale Internationale, 21/22-26 Mae Sot-Mae Tao road Tak63110, Thailand
  • d Première Urgence-Aide Médicale Internationale, Paris, France
  • e Thailand Ministry of Public Health, U.S. Centers for Disease Control and Prevention Collaboration, Ministry of Public Health, Tivanond Road, Nonthaburi, 11000, Thailand
  • f Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop E03, Atlanta, GA 30329, United States, Thailand Ministry of Public Health, U.S. Centers for Disease Control and Prevention Collaboration, Ministry of Public Health, Tivanond Road, Nonthaburi, 11000, Thailand
  • g Department of Disease Control, Thailand Ministry of Public Health, Tivanond Road, Nonthaburi, 11000, Thailand

Abstract

Background: During 2005-2012, surveillance in Maela refugee camp, Thailand, identified four cholera outbreaks, with rates up to 10.7 cases per 1000 refugees. In 2013, the Thailand Ministry of Public Health sponsored a two-dose oral cholera vaccine (OCV) campaign for the approximately 46,000 refugees living in Maela. Methods: We enumerated the target population (refugees living in Maela who are ≥1 year old and not pregnant) in a census three months before the campaign and issued barcoded OCV cards to each individual. We conducted the campaign using a fixed-post strategy during two eight-day rounds plus one two-day round for persons who had missed their second dose and recorded vaccine status for each individual. To identify factors associated with no vaccination (versus at least one dose) and those associated with adverse events following immunization (AEFI), we used separate marginal log-binomial regression models with robust variance estimates to account for household clustering. Results: A total of 63,057 OCV doses were administered to a target population of 43,485 refugees. An estimated 35,399 (81%) refugees received at least one dose and 27,658 (64%) received two doses. A total of 993 additional doses (1.5%) were wasted including 297 that were spat out. Only 0.05% of refugees, mostly children, could not be vaccinated due to repeated spitting. Characteristics associated with no vaccination (versus at least one dose) included age ≥15 years (versus 1-14 years), Karen ethnicity (versus any other ethnicity) and, only among adults 15-64 years old, male sex. Passive surveillance identified 84 refugees who experienced 108 AEFI including three serious but coincidental events. The most frequent AEFI were nausea (49%), dizziness (38%), and fever (30%). Overall, AEFI were more prevalent among young children and older adults. Conclusions: Our results suggest that mass vaccination in refugee camps with a two-dose OCV is readily achievable and AEFI are few. © 2015 .

Author Keywords

Oral cholera vaccines Thailand Refugees Epidemiology cholera

Index Keywords

household refugee binomial distribution Thailand sex ratio human Refugees middle aged priority journal pathology Aged oral drug administration nausea Administration, Oral procedures dizziness Cholera Vaccines cholera vaccine variance cholera cluster analysis disease surveillance Young Adult Humans Adolescent Infant, Newborn male preschool child Aged, 80 and over Infant very elderly Child, Preschool newborn female refugee camp Article Mass Vaccination mass immunization major clinical study adult fever dyspnea heart palpitation ethnicity Drug-Related Side Effects and Adverse Reactions Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84949726201&doi=10.1016%2fj.vaccine.2015.10.112&partnerID=40&md5=7b6d1c2fd04c2115e78223f5f2d5b6a3
DOI: 10.1016/j.vaccine.2015.10.112
ISSN: 0264410X
Cited by: 19
Original Language: English