The International Organization for Distributing Oral Cholera Vaccines during the outbreak has temporarily suspended the standard two-dose vaccination regimen and implemented a single-dose strategy in cholera outbreak response campaigns due to limited global supplies.
In a statement, the WHO said the pivot in the International Coordinating Group’s (ICG) strategy would allow doses to be used in more countries, at a time of unprecedented rise in cholera outbreaks around the world.
Cholera is an acute diarrheal infection of the small intestine that sometimes causes fatal dehydration. It is usually caused by food or water contaminated with Vibrio cholerae bacteria.
“This year 29 countries have reported outbreaks of cholera, including 13 that did not have outbreaks last year,” WHO chief Tedros Adhanom Ghebreyesus told reporters.
Haiti, Malawi and Syria are facing major outbreaks. In comparison, fewer than 20 countries on average reported outbreaks over the past 5 years.
The global trend is toward greater, more widespread and more severe outbreaks due to floods, droughts, conflict, population movements and other factors that limit access to clean water and risk cholera outbreaks. increase.
“A one-dose strategy has been shown to be effective for responding to outbreaks, even though evidence on the exact duration of protection is limited, and safety in children appears to be very low. With a two-dose, when a second dose If administered within the first 6 months, immunity against infection lasts for 3 years,” WHO said.
The announcement of Shanchol, an Indian subsidiary of French pharmaceutical giant Sanofi, will cease production by the end of the year, a factor contributing to rising levels of concern about the situation. Schenol is the manufacturer of one of only two cholera vaccines that can be used in human conditions.
“And there is no interruption in vaccine production by Sanofi, as we are continuing to deliver the Schenol dose,” however, a Sanofi spokesperson insisted, adding that the vaccine shortage was due to an increase in cases.
He explained that the company had announced its decision to cease production in 2020 because it was producing in small quantities, and because other actors had announced plans to increase capacity.
The benefit of supplying a single dose is still not greater than that of a dose: although temporary interruption of the two-dose strategy would result in further reduction of immunity, this decision would allow more people to be vaccinated and protect them in the near term, Should the global cholera situation continue to worsen, it adds.
According to the WHO, the current supply of cholera vaccines is extremely limited. Its use for emergency response is coordinated by the ICG which manages the global stockpile of oral cholera vaccines.
“Out of the total 36 million doses to be produced in 2022, 24 million have already been dispatched for preventive (17 per cent) and reactive (83 per cent) operations and an additional 8 million doses have been approved by the ICG for the second round. Vaccination in 4 countries shows severe vaccine shortage,” it adds.
Since vaccine manufacturers are producing at their maximum current capacity, there is no short-term solution to ramp up production. The WHO said the temporary suspension of the two-dose strategy would allow the remainder of the dose to be redirected to any requirement for the rest of the year.
This is a short-term solution but urgent action is needed to increase global vaccine production to mitigate the problem in the long term. The ICG will continue to monitor the status of the cholera vaccine stockpile along with global epidemiological trends and will regularly review this decision.
With inputs from agencies*
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