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Cholera is making a comeback — and the world doesn’t have enough vaccines

The global stockpile of the oral cholera vaccine — a supply whose needs are difficult to predict and fill anyway — has dwindled to nearly nothing after the Indian drug manufacturer that produced about 15 percent of the world’s supply stopped making the vaccine last year. While other companies are setting up new production capacity, the stockpile is now effectively nonexistent. Demand is so great that as soon as doses are produced, they must immediately ship to one of the world’s current cholera hot spots.

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Featured

 Cholera: vaccines can stop the spread, but the biggest deterrent is clean water

The first widely used cholera vaccines were injectable formulations. They were first developed in the late 19th and early 20th centuries. But they had side effects like headaches, malaise, nausea, fever and rash and offered only limited immune protection. In the 1980s these vaccines were replaced by safer and more effective oral cholera vaccines.

 Global Stockpile of Cholera Vaccine Is Gone as Outbreaks Spread

One company is going to great lengths to build it up, but it will be years before it returns to the minimum level.

Articles of Interest

A New, Longer-Lasting Type of Cholera Vaccine

Current vaccines last only 2–5 years, and they don’t work very well in young children. Now, researchers reporting in ACS Infectious Diseases have developed a new type of cholera vaccine consisting of polysaccharides displayed on virus-like particles. The vaccine generated long-lasting antibody responses against V. cholerae in mice. Current cholera vaccines contain killed or weakened V. cholerae bacteria and are administered orally. They offer the lowest level and duration of protection in young children, who are commonly affected by cholera in endemic countries.

Cholera Outbreaks Surge Worldwide as Vaccine Supply Drains

A record number of outbreaks have been reported after droughts, floods and wars have forced large numbers of people to live in unsanitary conditions.

How vaccines and research can help prevent cholera outbreaks

The current cholera pandemic has lasted six decades and killed millions. Professor Jan Holmgren, who developed the world’s first effective oral cholera vaccine, tells us how a new generation of vaccines could help control outbreaks and protect people’s health.

Shortage of cholera vaccines leads to temporary suspension of two-dose strategy, as cases rise worldwide

The exceptional decision reflects the grave state of the cholera vaccine stockpile.

Why is the world experiencing a cholera vaccine shortage?

"Cholera vaccines have never been a priority for manufacturers, and in many cases governments have not engaged as acknowledging cholera can have implications for commerce," said Gordon Dougan, a professor in the department of medicine at the University of Cambridge and a member of the board of management at the Wellcome Sanger Institute in the United Kingdom.

Why the Global Cholera Vaccine Shortage Goes Unnoticed Despite High Demand

The world has produced tens of billions of COVID-19 vaccine doses over the last two years. The technological challenge at hand with scaling cholera vaccine production is a mere fraction of what we just accomplished with COVID-19 vaccine production. We know it can be done. What is standing in our way is a lack of political will.

Resources

Oral Vaccines

Currently there are three WHO pre-qualified oral cholera vaccines (OCV): Dukoral®, Shanchol™, and Euvichol®. All three vaccines require two doses for full protection. Dukoral® is administered with a buffer solution that, for adults, requires 150 ml of clean water. Dukoral can be given to all individuals over the age of 2 years

Euvichol-Plus

Euvichol-Plus®is an oral cholera vaccine for the prevention of cholera occurring mainly in Africa and Asia. Euvichol-Plus® has been supplied to low and middle income countries which are cholera endemic or regularlyexperience the cholera outbreak through the WHO Stockpile funded by Global Alliance for Vaccines and Immunizations (GAVI) after receiving WHO PQ certification.

Vaxchora

Vaxchora is a vaccine indicated for active immunization against disease caused by Vibrio cholerae serogroup O1 in persons 2 through 64 years of age traveling to cholera-affected areas.