Cholera Vaccines

Cholera Vaccines 2024

The U.S. Food and Drug Administration (FDA), the European Medicine Agency (EMA), the World Health Organization (WHO), and the U.K. NHS recommend oral cholera vaccines (OCV) for specific conditions in countries that are undergoing outbreaks. As of October 2024, the World Health Organization (WHO) has prequalified Dukoral®, Shanchol™, and Euvichol® OCVs. On April 17, 2024, the WHO also prequalified the EuBiologics, and IVI produced the Euvichol-S vaccine.

The International Coordinating Group (ICG) on Vaccine Provision manages and coordinates the provision of OCV supplies. The vaccine dashboard is updated for October 2024.

Cholera Vaccines

In 2024, cholera vaccination is not generally recommended because most international travelers do not visit cholera outbreaks. The WHO says that all OCVs require two vaccine doses for complete protection for up to three years, while a single dose provides short-term protection. GAVI says in the current outbreak context, only one OCV dose course has been implemented in reactive vaccination campaigns. The U.K. Health Security Agency published an updated cholera vaccination guidance (chapter 14) in August 2024.

Dukoral® is administered with a buffer solution that requires 150 ml of clean water for adults. It can be given to all individuals over the age of 2.

Shanchol™ and Euvichol® are essentially the same vaccines produced by two different manufacturers.

Euvichol-Plus® is an inactivated OCV jointly developed by Eubiologics and the International Vaccine Institute for cholera prevention. Euvichol®-S improves productivity by approximately 40% over Euvichol-Plus®.

Vaxchora® (lyophilized CVD 103-HgR) is a single-dose, oral vaccine that the U.S. FDA approved in June 2016. The safety and effectiveness of VAXCHORA have not been established in immunocompromised persons. In August 2023, the U.S. Centers for Disease Control and Prevention (CDC) published Cholera Vaccine: Recommendations, highlighting CVD 103-HgR (Vaxchora®) for travelers going to areas of active toxigenic Vibrio cholerae O1 transmission.

HILLCHOL (BBV131) is a novel single-strain OCV developed by Bharat Biotech International Limited under license from Hilleman Laboratories. It is a two-dose vaccine that BBIL says needs to be orally administered on Day 0 and Day 14. The vaccine is suitable for individuals aged over one year.

Cholera Vaccine Availability

The International Coordinating Group (ICG) for OCVs was created in 1997 to manage the global stockpile. Since its establishment, the WHO, UNICEF, and Médecins sans Frontières have facilitated about 73 million doses of OCV for 23 countries. As of 2024, the WHO stated the ongoing global cholera response has been affected by a critical shortage of OCVs. Global production capacity in 2024 is forecast to be 37-50 million doses. As of April 2024, South Korea-based EuBiologics is the only OCV supplier to the global stockpile.

Cholera Outbreaks

Cholera outbreaks continued in 2024. 

Cholera Vaccine News 2024

October 17, 2024 - The WHO reported that OCVs are unavailable.

August 15, 2024 - The WHO reported that the global cholera response continues to be affected by a critical shortage of OCVs as demand continues to outpace supply. Since January 2023, 18 countries have requested 105 million doses, nearly double the 55 million doses produced in this period.

April 15, 2024 - EuBiologics and IVI announced that Euvichol-S achieved WHO prequalification.

March 20, 2024 - The WHO stated: We appeal to vaccine manufacturers, governments, donors, and partners to prioritize an urgent scale-up of vaccine production and invest in all the efforts needed to prevent and control cholera. 

February 12, 2024 - The WHO published situation report #11.

December 7, 2023 - The WHO published report #9 regarding active cholera outbreaks.

November 2, 2023 - The WHO published a Multi-country cholera outbreak, External Situation Report #8.

August 28, 2023 - The Republic of Kenya vaccinated about 1.6 million people with OCVs in August 2023.

June 1, 2023 - The WHO published a Multi-country cholera outbreak, External Situation Report #3.

May 15, 2023 - The WHO published a Multi-country cholera outbreak, External Situation Report #2.

March 22, 2023 - The WHO published - Multi-country Cholera Outbreaks, External Situation Report #1.

December 5, 2022 - The U.S. CDC published Travelers Returning to the U.S. with Cholera – Information and CDC Guidance for Healthcare Providers.

October 19, 2022—The WHO Director-General stated that four agencies decided to suspend the two-dose OCV vaccination strategy in favor of a one-dose approach so that more people receive some protection from limited stocks.