3.6 Vaccination against cholera

Vaccination against cholera should complement other prevention and control measures described in this chapter.

3.6.1 Oral cholera vaccines

To date, there are three WHO pre-qualified oral cholera vaccines (OCVs):

SHANCHOL® is a killed whole-cell bivalent vaccine containing Vibrio cholerae O1 (classical and El Tor) and O139.
It is administered in 2 doses to everyone over 12 months, with an interval of at least 14 days between each dose. In a clinical trial, it has shown 65% efficacy up to 5 years after vaccination [1] Citation 1. Sujit K Bhattacharya, Dipika Sur, Mohammad Ali. 5 year efficacy of a bivalent killed whole-cell oral cholera vaccine in Kolkata, India: a cluster-randomised, double-blind, placebo-controlled trial, Lancet, Published Online October 18, 2013.
http://dx.doi.org/10.1016/S1473-3099(13)70273-1 .

EUVICHOL®/EUVICHOL-PLUS® is a killed whole-cell bivalent vaccine containing Vibrio cholerae O1 (classical and El Tor) and O139.
It is administered in 2 doses to everyone over 12 months, with an interval of at least 14 days between each dose.
EUVICHOL®/EUVICHOL-PLUS® has the same formulation, immunogenicity and safety profile as SHANCHOL®. No field efficacy or effectiveness data are yet available.

Note: in certain contexts, the vaccine is given as a single dose, see Section 4.7.5.

DUKORAL® is a killed whole-cell monovalent vaccine containing Vibrio cholerae O1 (classical and El Tor) and purified recombinant B-subunit of cholera toxin (WC/rB).
The vaccine suspension must be mixed with a buffer solution.
The vaccine is administered in 3 doses to children 2 years to < 6 years of age and in 2 doses to children ≥ 6 years of age and adults. Each dose should be administered minimum 1 week to maximum 6 weeks apart.
This vaccine is not currently used for mass vaccination campaigns.

For more information, see Appendix 9, the manufacturer’s instructions, and the list of WHO prequalified vaccines a Citation a. https://extranet.who.int/gavi/PQ_Web/ .

3.6.2 Oral cholera vaccine stockpile

A global stockpile of OCV has been created for use during an outbreak or humanitarian emergency. A formal request to the International Coordinating Group on vaccine provision (ICG) is required, using forms available on the WHO website b Citation b. http://www.who.int/cholera/vaccines/ocv_stockpile_2013/en/ .