Technical Note Evidence of the risks and benefits of vaccinating pregnant women with WHO pre-qualified cholera vaccines during mass campaigns November 2016

Background

Three oral cholera vaccines (OCVs) are currently pre-qualified by WHO: Dukoral, Shanchol, and Euvichol All are oral killed whole-cell (WC) vaccines that provide sustained protection of >50% for at least two years in endemic populations, induce an immune response relatively quickly (7-10 days after the 2nd dose) and have a good safety profile. Shanchol has demonstrated longer term protection – 65% over five years – as compared to Dukoral. On the other hand, Dukoral has been shown to provide better short-term protection against cholera, particularly among children 2-5 years old and also confers significant short-term protection against ETEC (≈50% for three months). Shanchol and Euvichol have the same formulation and comparable safety and immunogenicity profiles.  Both are reformulated versions of Dukoral without the B subunit of the cholera toxin (no need for buffer). All three vaccines have a two-dose regimen with doses given between one and six weeks apart (three doses for Dukoral in children aged 2–5 years).