Cholera

Oral cholera vaccines

Global efforts to control resurgence of cholera worldwide are now entering a new phase following the development of safe and effective oral cholera vaccines (OCV).These new tools have opened up the possibility of preventing outbreaks among the most vulnerable populations living in high risk areas, where usually recommended control measures are not sufficient.

WHO recommendations advise that immunization should be used with other prevention and control strategies in areas where the disease is endemic and in areas at risk for outbreaks. The use of OCVs should also be considered reactively to reduce mortality in areas where other interventions cannot be delivered effectively. As such OCV use is part of a multidisciplinary approach and should be considered within the wider scope of public health priorities.

Experience gained from different mass vaccination campaigns in Mozambique, Indonesia , Sudan and Zanzibar clearly indicates that mass vaccination campaigns cannot be improvised at the last moment – they need careful advance planning and preparation, while major challenges remain, including improving the assessment of risk, identification of target populations and logistics.

Currently WHO is facilitating a multi-partner initiative aimed at establishing an OCV stockpile along with criteria for its use and monitoring. This should allow access to sufficient vaccines for outbreak response as an adjunct to established prevention and control measures, particularly in complex emergency settings.