Suspension of two-dose cholera vaccine could be dangerous for children

The World Health Organisation (WHO) has announced a shortage of the cholera vaccine due to cases increasing worldwide.

International Coordinating Group (ICG), an international body which manages emergency supplies of vaccines, has temporarily stopped the standard two-dose vaccine rollout in cholera outbreak response campaigns.

The one-dose strategy has proven to be effective to respond to outbreaks, despite evidence on the exact duration of protection being limited and it being much lower in children.

Founded in 1997, the ICG set to distribute 36 million doses of the cholera vaccine this year, but 24 million have already been shipped for preventive and reactive campaigns. 

As well as this, an additional eight million doses have been approved by the ICG for the second round of emergency vaccination in four countries, showing the dire shortage.

Since January 2022, 29 countries have reported Cholera cases including Haiti, Malawi and Syria whereas in the last five years, less than 20 countries reported outbreaks.

With a two-dose regimen, when the second dose is administered within six months of the first, immunity against the bacterial infection lasts for three years.  

Commenting on the issue, the ICG, which is composed of members of WHO, Medecins Sans Frontieres, UNICEF and the International Federation of Red Cross and Red Crescent Societies, said: ‘As vaccine manufactures are producing at their maximum current capacity, there is no short-term solution to increase production. 

‘The temporary suspension of the two-dose strategy will allow the remaining doses to be redirected for any needs for the rest of the year.’

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

Since the establishment of the cholera vaccine stockpile in 2013, 120 million doses have been shipped to 23 countries, of which 60% has been approved for emergency response.

Photo by Viktor Forgacs