Overview
Protects against cholera, a severe diarrhoeal disease caused by Vibrio cholerae bacteria, spread through contaminated water.
Generally not recommended for routine travellers. May be considered for aid workers, healthcare workers, and travellers to active cholera outbreak areas with limited access to safe water and medical care. Provides some cross-protection against enterotoxigenic E. coli (ETEC), a common cause of traveller's diarrhoea.
Vaccination Schedule
Standard schedule: Adults and children 6 years and older: 2 oral doses given 1-6 weeks apart. Children aged 2-5 years: 3 oral doses given 1-6 weeks apart.
Accelerated schedule: Minimum interval between doses is 1 week. No further acceleration possible.
Route: Oral suspension. Each dose is mixed with a buffer solution (bicarbonate granules dissolved in water) and drunk on an empty stomach. No food or drink for 1 hour before and after.
Brands Available in Australia (TGA-Registered)
- Dukoral (Valneva)
Cost in Australia
Estimated cost: $60-$90 for the 2-dose adult course
Medicare/PBS: Not funded under NIP or PBS. Available on private prescription.
Efficacy & Duration
Efficacy: 60-85% protective efficacy against cholera in the first 6 months
Provides approximately 60-85% protection against cholera for 6 months after vaccination, declining to about 60% at 2 years. Cross-protection against ETEC traveller's diarrhoea is modest (approximately 50-60%) and short-lived.
Duration of protection: Protection against cholera lasts approximately 2 years for adults. Booster required every 2 years if ongoing risk. For children 2-5 years, protection may be shorter (6 months).
Side Effects
| Side Effect | Frequency |
|---|---|
| Abdominal pain, diarrhoea, nausea | Common (10-50%) |
| Headache, fatigue, malaise | Common (10-50%) |
| Vomiting, fever, loss of appetite | Uncommon (1-10%) |
Contraindications
- Severe allergic reaction to a previous dose or vaccine component (including formaldehyde)
- Acute gastrointestinal illness (defer until resolved)
- Children under 2 years of age
Special Populations
Pregnancy
Category B2. Limited data in pregnancy. Can be considered if the risk of cholera is significant. Inactivated oral vaccine, not systemically absorbed.
Children
Licensed from 2 years of age. Children aged 2-5 years require 3 doses (instead of 2) and may have shorter duration of protection. Not licensed under 2 years.
Immunocompromised Travellers
Safe to administer as an inactivated vaccine. Immune response may be reduced. Consider on a case-by-case basis. Emphasise food and water hygiene measures as the primary prevention strategy.
Frequently Asked Questions
Do I need cholera vaccine for travel?
For most tourists, cholera vaccination is not necessary. The risk to travellers staying in standard accommodation and practising basic food and water hygiene is very low. It may be considered for aid workers, those travelling to active outbreak zones, or those with limited access to safe water and medical facilities.
Does Dukoral protect against traveller's diarrhoea?
Dukoral provides modest cross-protection (about 50-60%) against traveller's diarrhoea caused by enterotoxigenic E. coli (ETEC), which accounts for roughly 30-40% of traveller's diarrhoea cases. Protection is short-lived (about 3 months). It does not protect against other causes of traveller's diarrhoea.
How much does the cholera vaccine cost?
Dukoral costs approximately $60-$90 for the adult 2-dose course. It is not covered by Medicare or the PBS. The cost-effectiveness for routine travellers is generally poor given the low risk and modest efficacy.
How do you take the cholera vaccine?
Dukoral is an oral vaccine. You dissolve the buffer granules in a glass of water, then add the vaccine vial contents and drink the mixture. You must avoid food and drink for 1 hour before and after each dose. Take it on an empty stomach.
How long does cholera vaccination last?
Protection lasts approximately 2 years for adults and possibly shorter for children under 6. A single booster dose is recommended every 2 years if you continue to travel to high-risk areas.
Is there a cholera risk in Bali or Thailand?
The cholera risk for tourists in Bali and Thailand is very low. Cholera outbreaks are more commonly associated with humanitarian crises, displaced populations, and areas with severely compromised water and sanitation infrastructure. Standard food and water precautions are sufficient for most tourists.
Can children take the cholera vaccine?
Dukoral is licensed from 2 years of age. Children aged 2-5 years require 3 doses instead of 2. The vaccine is generally not recommended for routine paediatric travellers due to the low risk of cholera in typical travel settings.
Is the cholera vaccine a drink or an injection?
Dukoral is an oral vaccine (a drink). There is no injectable cholera vaccine available in Australia. The vaccine is mixed with a buffer solution and water, then swallowed. Most people find it tolerable though the taste is slightly salty.
Sources & References
Last updated: April 2026