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

A strained global supply of cholera vaccines has obliged the International Coordinating Group (ICG) — the body which manages emergency supplies associated with vaccines — to temporarily suspend the standard two-dose vaccination regimen in cholera outbreak response campaigns, using instead a single-dose approach.  

The pivot in strategy will allow for the doses to be used in more countries, at a time of unprecedented rise inside cholera outbreaks worldwide.

Since January this year, 29 countries have reported cholera cases, including Haiti, Malawi and Syria which are facing large outbreaks. In comparison, in the previous 5 years, fewer than 20 countries on average reported outbreaks. The particular global trend is moving towards more numerous, more widespread and more severe breakouts, due to floods, droughts, conflict, population movements and other factors that limit access in order to clean water and raise the risk of cholera outbreaks.

The one-dose strategy has proven to be effective to respond to episodes, even though evidence on the exact duration of protection is limited, and protection appears to be much lower in children.   With a two-dose routine, when the particular second dose is administrated within 6 months of the first, immunity against infection lasts for 3 many years.

The benefit of supplying one dose still outweighs no dosages: although the temporary interruption associated with the two-dose strategy will lead in order to a reduction and shortening of defenses, this decision will allow a lot more people to become vaccinated plus provide them protection in the near term, should the global cholera situation continue deteriorating.

The particular current supply of cholera vaccines is extremely limited. Its use with regard to emergency response is   coordinated by the ICG which manages the worldwide stockpile of oral cholera vaccines. Of the total 36 million doses forecast to end up being produced in 2022, 24 million have already been shipped for preventive (17%) and reactive (83%) campaigns plus an additional 8 million doses were approved by the particular ICG for the second round for crisis vaccination in 4 nations, illustrating the dire shortage of the particular vaccine. As vaccine manufactures are producing at their maximum current capacity, there is no short-term solution to increase production. The temporary suspension system of the two-dose technique enables the particular remaining doses to be redirected regarding any needs for the rest associated with the year.

This is the short-term answer but to ease the particular problem in the longer term, urgent action is needed to increase global vaccine production.

The particular ICG will certainly continue in order to monitor the global epidemiological trends as well as the status from the cholera shot stockpile, and will review this particular decision regularly.

About the particular ICG

The ICG is an international group that manages and coordinates the provision of emergency vaccine supplies plus antibiotics to countries during major disease outbreaks.   It handles the global stockpile associated with the oral cholera shot. The group is composed of members of WHO, Médecins Sans Frontières, UNICEF and the International Federation of Red Cross and Red Crescent Societies.

The ICG was established in 1997, following major outbreaks associated with meningitis within Africa, because a mechanism to manage and coordinate the provision of emergency vaccine supplies and antibiotics to countries during main outbreaks.

Given that the establishment of the particular cholera vaccine stockpile inside 2013, 120 million dosages of dental cholera shot doses have been delivered to 23 countries, of which 73 million (60%) has been approved intended for emergency reaction.


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