Cholera vaccine shortage caused one-dose strategy

The World Health Organisation said a strained global supply of cholera vaccines has obliged the International Coordinating Group to temporarily suspend the standard two-dose vaccination regimen in cholera outbreak response campaigns, using instead a single-dose approach.

The shift in strategy will allow the doses to be used in more countries during a period of unprecedented global cholera outbreaks.

The ICG is an international group that manages and coordinates the provision of emergency vaccine supplies and antibiotics to countries during major disease outbreaks. It manages the global stockpile of the oral cholera vaccine.

The group is composed of members of WHO, Médecins Sans Frontières, UNICEF, and the International Federation of Red Cross and Red Crescent Societies.

In a press statement on Wednesday, the WHO said since January this year, 29 countries have reported cholera cases, including Haiti, Malawi, and Syria, which are facing large outbreaks.

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The statement read in part, “The one-dose strategy has proven to be effective to respond to outbreaks, even though evidence on the exact duration of protection is limited, and protection appears to be much lower in children. When with a two-dose regimen, when the second dose is administered within 6 months of the first, immunity against infection lasts for three years.

“The benefit of supplying one dose still outweighs no doses; although the temporary interruption of the two-dose strategy will lead to a reduction and shortening of immunity, this decision will allow more people to be vaccinated and provide them protection in the near term, should the global cholera situation continue deteriorating.

“The current supply of cholera vaccines is extremely limited. Its use for emergency response is coordinated by the ICG, which manages the global stockpile of oral cholera vaccines. Of the total 36 million doses forecast to be produced in 2022, 24 million have already been shipped for preventive (17 per cent) and reactive (83 per cent) campaigns and an additional eight million doses were approved by the ICG for the second round of emergency vaccination in four countries, illustrating the dire shortage of the vaccine.

“This is a short-term solution, but to ease the problem in the long term, urgent action is needed to increase global vaccine production.

“The ICG will continue to monitor the global epidemiological trends as well as the status of the cholera vaccine stockpile, and will review this decision regularly.”

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