Cholera and travellers' diarrhea vaccine#

Information about the oral vaccine that helps protect against cholera and the most common bacterial cause of travellers' diarrhea (ETEC), who should consider it, how it is taken, and how TeleTest can help.

The cholera and travellers' diarrhea vaccine is an oral (drunk, not injected) vaccine that helps protect against cholera and against travellers' diarrhea caused by a common bacteria called Enterotoxigenic Escherichia coli (ETEC). It is taken as a series of doses before travel and is one of the few travel vaccines you can give to yourself at home.

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What this vaccine is and why it matters#

Cholera is an infection caused by bacteria in contaminated water or food. It can lead to severe watery diarrhea and dehydration, and in untreated severe cases it can be life-threatening. It is rare in Canada but occurs in some parts of South Asia, Sub-Saharan Africa, Haiti, and other regions with limited access to safe drinking water and sanitation.

Travellers' diarrhea is the most common illness in people travelling abroad. ETEC is one of the leading bacterial causes, especially in South Asia, Southeast Asia, Latin America, and parts of Africa. Most episodes are mild and resolve on their own, but they can disrupt a trip and can be more serious for some travellers.

The oral cholera and travellers' diarrhea vaccine helps the immune system of the gut recognize and respond to these specific bacteria. It does not protect against the many other germs that cause travellers' diarrhea (other bacteria, viruses, and parasites), so good food and water habits still matter.

Who should consider it#

Most travellers do not need this vaccine. It tends to be most useful for:

  • Travellers to regions with active cholera outbreaks, especially aid workers, healthcare workers, or those in disaster relief
  • People who cannot easily tolerate a brief illness during the trip (work or performance commitments where being unwell would be a big problem)
  • Travellers with conditions that make travellers' diarrhea more dangerous, including chronic kidney disease, heart failure, insulin-treated diabetes, inflammatory bowel disease, or weakened immune systems
  • People with reduced stomach acid (for example, on long-term acid-suppressing medications, or after stomach surgery), as low stomach acid makes infection from contaminated food easier
  • Children aged 2 and older travelling to high-risk areas

It is generally not needed for short, low-risk trips to resort areas with reliable food and water.

How TeleTest helps#

TeleTest is an online consultation service. Here is what we do and do not do for this vaccine:

  • What we do. Our clinicians can review your travel plans, health history, and medications, and (if appropriate) write a prescription for the oral cholera and travellers' diarrhea vaccine. Because it is oral and self-administered, you do not need to visit a travel clinic to receive it. We can also provide guidance on food and water precautions, oral rehydration, and when self-treatment of diarrhea with antibiotics may be reasonable.
  • What we do not do. We do not stock vaccines on site, and we do not administer injectable travel vaccines (yellow fever, Japanese encephalitis, typhoid by injection, rabies pre-exposure, and so on). Those are arranged through a travel-medicine clinic, public health unit, or, in some provinces, a pharmacy. We are also not a substitute for an in-person travel-medicine visit if you are heading somewhere with multiple high-risk exposures.

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Common questions#

How long before travel should I take the vaccine?#

The series should be completed at least one week before you depart, so the gut immune response has time to develop. For adults and children aged 6 and older, this means two doses given at least one week apart (and not more than six weeks apart). For children aged 2 to less than 6, three doses are given.

If you finish the series with less than one week before travel, you still get some benefit, but full protection may not be in place when you arrive.

How long does protection last?#

Protection against cholera lasts about two years in people aged 6 and older, and about six months in children aged 2 to less than 6. Protection against ETEC travellers' diarrhea is shorter - typically up to about three months. A booster dose is needed if you are at ongoing risk after these intervals.

How effective is it?#

Against cholera in the first six months, protection is high (over 80% in studies in endemic regions). Against ETEC travellers' diarrhea, the protection is modest - studies suggest around an additional 5-15% reduction over and above good food and water practices, depending on the destination and the strains of ETEC involved.

This is why the vaccine is best thought of as one layer of prevention. It does not replace careful eating, hand washing, safe water, and self-treatment of any breakthrough diarrhea.

How is it taken?#

It is mixed with a buffer solution and drunk on an empty stomach. You should not eat, drink, or take medications for one hour before and one hour after each dose, because food or drink can reduce how well the vaccine works.

Each dose is separated by at least one week (and not more than six weeks) from the next dose.

What are the common side effects?#

Most people have no side effects. Some people get mild stomach upset, nausea, headache, or a brief episode of diarrhea, which is usually from the buffer solution rather than the vaccine itself. These settle on their own.

Severe allergic reactions (anaphylaxis) are extremely rare.

Who should not take it?#

People with a known severe allergy to any component of the vaccine, or who had a serious reaction to a previous dose, should not take it. The vaccine should also be delayed in people who are acutely unwell with vomiting, diarrhea, or a significant febrile illness.

It is not recommended for children under 2, because effectiveness in that age group has not been established.

Is it safe during pregnancy or breastfeeding?#

There are no controlled studies in pregnancy. Because it is an oral vaccine that is not absorbed into the bloodstream in a meaningful way, it can be considered in pregnant travellers heading to high-risk areas after weighing the risks and benefits with a clinician. It is generally considered acceptable while breastfeeding.

Can I take it with other travel vaccines?#

It can be given with most other travel vaccines. The main exception is oral typhoid (which is also taken by mouth) - those should be separated by at least 8 hours, ideally with the oral typhoid taken first. There is no known problem combining the cholera/ETEC vaccine with the hepatitis A and B combined vaccine, the meningococcal vaccine, the yellow fever vaccine, or other common travel vaccines.

Does it replace antibiotics for travellers' diarrhea?#

No. The vaccine only covers some causes of travellers' diarrhea. Many travellers heading to high-risk regions still benefit from carrying a short course of antibiotics for self-treatment of moderate-to-severe diarrhea, plus oral rehydration salts. Discuss this in your travel consultation.

Do I still need to be careful with food and water?#

Yes. Food and water precautions are the single most important way to avoid cholera and travellers' diarrhea. Drink only sealed bottled or treated water, avoid ice from unknown sources, eat foods that are thoroughly cooked and served hot, peel fruit yourself, and wash your hands or use alcohol-based hand sanitizer often.

I had the vaccine years ago. Do I need a booster?#

If your last dose was more than two years ago (for cholera protection) or more than three months ago (for ETEC protection), and you are heading back to a risk area, you typically need a booster - usually a single oral dose, but check with the clinician at the time of your consultation.

Can I give myself the vaccine at home?#

Yes. This is one of the main advantages of this vaccine. It is sold in a kit at the pharmacy and includes the buffer powder and the vaccine vial. You mix them and drink the solution. Follow the pharmacist's or product instructions carefully.

I am immunocompromised. Can I take it?#

Yes - because this is not a live virus vaccine in the traditional sense (it is a killed-cell oral vaccine), it is generally considered safe in people with weakened immune systems, including those with HIV. However, the immune response may be weaker, so additional precautions with food, water, and possibly antibiotics for self-treatment are important. Discuss this individually.

Cost and coverage#

The vaccine kit is not covered under provincial health plans. Most private and workplace drug plans, and some travel-insurance plans, cover the cost in part or in full - check with your plan. Out-of-pocket pricing at most Canadian pharmacies is in the range of about $90-$130 per kit; prices vary by pharmacy, so price-shopping is reasonable, especially if your family is buying more than one.

TeleTest charges a consultation fee for the travel review and prescription. A receipt is available for reimbursement through private or workplace insurance plans, or for travel-insurance claims.

Request a TeleTest travel consultation#

Last reviewed: Spring 2026. Reviewed by Dr. Mohan Pandit, Chief Medical Officer at TeleTest. We review this page periodically as medical guidelines, lab practices, and provincial programs evolve. This page is for general information, not personal medical advice. If you've noticed information that may be out of date or have suggestions, please contact us - we appreciate the help keeping these resources accurate.

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