An oral vaccine for cholera. Photo by: Niklas Morberg / CC BY-NC

ABIDJAN — Distribution of roughly half a million doses of the global cholera vaccine stockpile began in Sierra Leone last week in the first round of a campaign to prevent a widespread cholera outbreak following massive mudslides that killed hundreds of people this August.

After a request by the government of Sierra Leone, UNICEF, and the World Health Organization, the Global Alliance for Vaccines and Immunization made a donation “on a compassionate basis,” of 1 million doses amid fears of a major outbreak if vulnerable communities are left untreated.

The whole campaign will unfold in two stages, with each one distributing a single dose to roughly half a million people. The Sierra Leone second round campaign takes place Oct. 5-10.

Janet Kayita, lead of essential health services at WHO Sierra Leone, told Devex that based on the circumstances in Sierra Leone, the decision was “justified.”

“Based on the pre-existing water and sanitation infrastructure and an analytical approach that assessed the situation of the communities affected, the water and sanitation practices, the health infrastructure and protection against outbreak, the risk was very high that we could have a cholera outbreak,” she said.

Access to safe water and sanitation remains limited, and with a public health system still recovering from the 2014 Ebola outbreak, the chance of cholera quickly spreading in areas still in need of humanitarian assistance and reaching people still in temporary shelters seemed imminent, Ministry of Health spokesperson Harold Thomas explained.

“[It would] be devastating in those settings where people are already displaced, so the point is to prevent that,” Thomas said.

This oral cholera vaccination campaign is the first of its kind in Sierra Leone, targeting 25 communities in Western Freetown deemed to have the most vulnerable populations. However, past experiences distributing vaccines, such as for typhoid, working with vaccination teams, community mobilizers, and local networks indicated that Sierra Leone would be a successful host to such a campaign, Kayita added.

Sierra Leone is no stranger to cholera outbreaks. During the 2012 rainy season, the same Western Freetown area saw the country’s worst outbreak in decades, which included at least 25,000 confirmed cases and 390 deaths.

To avoid a repeat of that history, the vaccine is offered free of charge for everyone over 1 years old living in the targeted communities. This effort is being coupled with other preventative measures, including the use of water purification tablets and the construction of proper restroom facilities. Since the August 14 flooding and mudslide, no confirmed cases of cholera have so far been detected to date.

Prior to distribution, information about the upcoming vaccination campaign was announced in government-sponsored television and radio advertisements. Thomas said a major part of the communication strategy was an emphasis on the importance of the vaccine and to explain why only certain communities were eligible.

“What impressed me on the very first day was the high demand and activity around the vaccine,” Kayita told Devex. “I found people lining up waiting to receive the vaccine, so the message clearly has gone out about what’s happening and when.”

With rainy season typically lasting another month, Thomas recalled the need for vigilance and continued proper sanitation practices. “We are not out of the woods yet because it’s still the rainy season. But for these next two to four weeks, we are keeping our fingers crossed and advising people to take precaution.”

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