User/Whispyhistory/vaccines/cholera vaccines

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There are several brands of cholera vaccine, all of which are only partially effective, and prevention of cholera requires good sanitation and clean water.[1][2][3] There are three killed oral cholera vaccines (kOCVs) prequalified by WHO for use in endemic areas; Dukoral, Euvichol-Plus and Shanchol.[1] Vaxchora is a single dose live attenuated oral cholera vaccine licensed in the US.[1] As of 2017, the WHO recommends kOCVs for use in endemic areas, during certain crises and outbreaks. Since 2014, 15 countries utilised millions of WHO stockpiled cholera vaccines.[1]

Cholera vaccine
Name Type administation Recommendations Instruction Comments Effectiveness History/social
Euvichol-Plus Bivalent vaccine killed whole cell mixtures of 01 and 0139 serogroup V. cholera.[1] By mouth.[3] 2-dose course two-weeks apart.[1][4] Use in endemic areas during certain crises and outbreaks.[1] Used in age over 12 months.[4] After shaking the vaccine container rigorously, 1.5 mL of the vaccine should be squirted into the mouth, with or without. sip of water.[5] Eubiologics, Seoul, Korea.[1] It can survive without the cold chain storage for several weeks.[1] Stockpiled by WHO.[1] Low cost.[4] In the first 2 years after vaccination it is around 66% effective in older children and adults and 38% effective in children under age 5 years.[1] First produced in 2011 and WHO prequalified in 2017.[6] Available in plastic tubes.[6]
Shanchol Bivalent vaccine killed whole cell mixtures of 01 and 0139 serogroup V. cholera.[1] By mouth.[3] 2-dose course two-weeks apart.[1][4] Use in endemic areas during certain crises and outbreaks.[1] Used in age over 12 months.[4] Shantha Biotechnics-Sanofi Pasteur, India.[1] Cheapest.[3] Few side effects.[3] It can survive without the cold chain storage for several weeks.[1] Stockpiled by WHO.[1] In the first 2 years after vaccination it is around 66% effective in older children and adults and 38% effective in children under age 5 years.[1] OR 52% effective in first year, 62% in second.[3] Licensed in India in 2009.[6]
Dukoral Killed whole cell containing only 01 serogroup V. cholera with the CTB-subunit.[1] By mouth.[1] 2-dose course.[3] Licensed in Europe and Canada for age over 2-years in certain travellers at high risk.[1][3] 2 doses 1 to 6 weeks apart.[3] If more than 6 weeks interval between first 2 doses then course needs restarting.[3] Booster (within 6 months of primary course in under 2 year olds, within 2 years in over 6 year olds) if continuous protection needed.[3][7] Valneva, France.[1] Supplied as granules and a separate buffer suspension.[3] In the first 2 years after vaccination it is around 66% effective in older children and adults and 38% effective in children under age 5 years.[1] Effectiveness wanes rapidly after 6 months.[3] WHO prequalified in 2001.[6]
Vaxchora Live attenuated[2] By mouth, one dose only.[2] One dose 10 days before travel to high risk areas.[2] It is taken by mouth, avoiding eating and drinking for one hour before and after taking it.[2] Emergent Biosolutions for certain travellers in the US[1] It comes in 2 packets and is stored away from light and moisture, and in the cold but not frozen.[2] May reduce risk of severe diarrhea in people by 90% at 10 days after vaccination and by 80% at 3 months after vaccination.[8] Licensed for use in the US in 2016.[2]

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References

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 Weil, Ana A.; Ryan, Edward T. (2022). "66. Cholera". In Jong, Elaine C.; Stevens, Dennis L. (eds.). Netter's Infectious Diseases (2nd ed.). Philadelphia: Elsevier. pp. 388–389. ISBN 978-0-323-71159-3. Archived from the original on 2022-02-24. Retrieved 2022-02-24.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Bonville, Cynthia; Domachowske, Joseph (2021). "8. Cholera". In Domachowske, Joseph; Suryadevara, Manika (eds.). Vaccines: A Clinical Overview and Practical Guide. Switzerland: Springer. pp. 111–119. ISBN 978-3-030-58416-0. Archived from the original on 2022-02-23. Retrieved 2022-02-23.
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 Prevatt, Natalie; Behrens, Ron H. (2021). "23. Paediatric vaccines for travel outside Europe". In Vesikari, Timo; Damme, Pierre Van (eds.). Pediatric Vaccines and Vaccinations: A European Textbook (Second ed.). Switzerland: Springer. pp. 272–273. ISBN 978-3-030-77172-0. Archived from the original on 2022-02-24. Retrieved 2022-02-24.
  4. 4.0 4.1 4.2 4.3 4.4 "3.6 Vaccination against cholera - Management of a CHOLERA EPIDEMIC". medicalguidelines.msf.org. Archived from the original on 24 January 2021. Retrieved 27 February 2022.
  5. "Euvichol-Plus Full Prescribing Information, Dosage & Side Effects | MIMS Malaysia". www.mims.com. Archived from the original on 25 November 2020. Retrieved 27 February 2022.
  6. 6.0 6.1 6.2 6.3 Odevall, Lina; Hong, Deborah; Digilio, Laura; Sahastrabuddhe, Sushant; Mogasale, Vittal; Baik, Yeongok; Choi, Seukkeun; Kim, Jerome H.; Lynch, Julia (29 October 2018). "The Euvichol story - Development and licensure of a safe, effective and affordable oral cholera vaccine through global public private partnerships". Vaccine. 36 (45): 6606–6614. doi:10.1016/j.vaccine.2018.09.026. ISSN 1873-2518. PMID 30314912. Archived from the original on 26 February 2022. Retrieved 26 February 2022.
  7. "14. Vaccines". British National Formulary (BNF) (82 ed.). London: BMJ Group and the Pharmaceutical Press. September 2021 – March 2022. pp. 1366–1384. ISBN 978-0-85711-413-6.{{cite book}}: CS1 maint: date format (link)
  8. "Vaccines | Prevention and Control | Cholera | CDC". www.cdc.gov. 18 November 2020. Archived from the original on 1 February 2022. Retrieved 26 February 2022.

Further reading