4 February, 2023

Two-dose Cholera vaccine suspended as shortage grows

Shortage of cholera vaccines has led to temporary suspension of a two-dose strategy, as cases rise worldwide.

A strained global supply of cholera vaccines has forced the International Coordinating Group (ICG) to temporarily suspend the standard two-dose vaccination regimen in cholera outbreak response campaigns and adopt a single-dose approach.

The ICG is an international group that manages and coordinates the provision of emergency vaccine supplies and antibiotics to countries during major disease outbreaks. 

It is anticipated that the new strategy will allow for the doses to be used in more countries, at a time of unprecedented rise in cholera outbreaks worldwide.

Since January this year, 29 countries have reported cholera cases, including Haiti, Malawi and Syria which are facing large outbreaks.

So far, over 4,700 cases of the disease have been registered in Malawi and over 130 people have died.

Malawi received about 1.9 million doses in April and by May, there was a stock-out.

In a statement released on Wednesday afternoon, the World Health Organisation (WHO) confirms that the global trend is moving towards more numerous, more widespread and more severe outbreaks.

This has largely been attributed to floods, droughts, conflict, population movements and other factors that limit access to clean water and raise the risk of cholera outbreaks.

On the one-dose strategy, the WHO is confident that even though evidence on the exact duration of protection is limited, it has since proven to be effective to respond to outbreaks.

And with a two-dose regimen, when the second dose is administered within 6 months of the first, immunity against infection lasts for 3 years.

The statement further states that, “The benefit of supplying one dose still outweighs no doses: although the temporary interruption of the two-dose strategy will lead to a reduction and shortening of immunity, this decision will allow more people to be vaccinated and provide them protection in the near term, should the global cholera situation continue deteriorating.”

Of the total 36 million doses forecast to be produced this year, 24 million have already been shipped for with 17 percent of the doses being used for preventive campaigns while 83 percent will be used for reactive health campaigns.

An additional 8 million doses were approved by the ICG for the second round for emergency vaccination in 4 countries.

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