Abstract
The use of oral cholera vaccine (OCV) has increased since 2011, when Shanchol, the first OCV suitable for large-scale use, became available. Médecins Sans Frontières considers OCVs an essential cholera outbreak control tool and has contributed to generating new evidence on OCV use in outbreaks. We showed that large-scale mass campaigns are feasible during outbreaks, documented high short-term effectiveness and showed that vaccines are likely safe in pregnancy. We found that a single-dose regimen has high short-term effectiveness, making rapid delivery of vaccine during outbreaks easier, especially given the on-going global vaccine shortage. Despite progress, OCV has still not been used widely in some of the largest recent outbreaks and thousands of cholera deaths are reported every year. While working towards improving our tools to protect those most at-risk of cholera, we must strive to use all available effective interventions in efficient ways, including OCV, to prevent avoidable deaths today.
Highlights
The use of killed oral cholera vaccine (OCV) has increased since 2011, when Shanchol, the first OCV suitable for large-scale use, became available and was prequalified by the World Health Organization (WHO) [1]
We demonstrated high short-term single-dose vaccine effectiveness of 87.3% [9]
With the same 1-dose strategy we reached almost half a million people, and were able to confirm the shortterm effectiveness of this regimen (88.9%; 95% CI, 42.7%– 97.8%) in a population where cholera had not been reported for more than 4 years [10]. As it is unclear how long protection from a single dose may last, the campaign was followed with a second dose 8 months later, when more vaccine was available
Summary
The use of killed oral cholera vaccine (OCV) has increased since 2011, when Shanchol, the first OCV suitable for large-scale use, became available and was prequalified by the World Health Organization (WHO) [1]. Timeliness of reactive OCV campaigns, the logistic complexities of delivering the vaccine, and the persistent global shortage continue to hinder widespread OCV use. Médecins Sans Frontières considers OCV to be an essential outbreak control tool, complimenting case management and water/sanitation/hygiene interventions.
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