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Cholera vaccine

A cholera vaccine is a vaccine that is effective at reducing the risk of contracting cholera.[10] The recommended cholera vaccines are administered orally to elicit local immune response in the gut where the intestinal cells produce antibodies against the cholera microbe. This immune response was poorly achieved with the injectable vaccines that were used until the 1970s. The first effective oral cholera vaccine was Dukoral, developed in Sweden in the 1980s. For the first six months after vaccination it provides about 85% protection, which decreases to approximately 60% during the first two years.[10][11][12] When enough of the population is immunized, it may protect those who have not been immunized thereby increasing the total protective impact to more than 90 % (known as herd immunity).[10]

Vaccine description

Vibrio cholerae

Inactivated

Dukoral, Vaxchora, others

Micromedex Detailed Consumer Information

By mouth

  • none

The World Health Organization (WHO) recommends the use of three oral cholera vaccines – Dukoral, Shanchol, and Euvichol-Plus – in combination with other measures among those at high risk for cholera.[10] Two vaccine doses with a 1–6 week interval are typically recommended.[10] The duration of protection is at least two years in adults and six months in children aged 1–5 years.[10] A live, attenuated single dose oral vaccine is available for those traveling to an area where cholera is common but is not WHO approved for public health use.[13][14][15]


The available types of oral cholera vaccine are generally considered safe for the majority of the population.[10] These vaccines were shown to be safe in pregnancy and in those with poor immune function.[10] The main side effects which could be experienced includes mild abdominal pain or diarrhea may occur.[10]


The first cholera vaccines were developed in the late 19th century.[16] They were the first widely used vaccine that was made in a laboratory but were largely abandoned in the 1970s due to their then documented reactogenicity and poor efficacy .[16]


Oral cholera vaccines were first introduced in the 1990s.[10] It is on the World Health Organization's List of Essential Medicines.[17][18]


These vaccines are licensed for use in more than 60 countries.[10] In countries where the disease is common, the vaccine appears to be cost effective.[10]

Side effects[edit]

Both the inactivated and attenuated oral vaccines available are generally safe.[10] Some of the common side effects include mild abdominal pain or diarrhea.[10] They are safe in pregnancy and in those with poor immune function.[10]

The first known attempt at a cholera vaccine was made by and it was aimed at preventing cholera in chickens.[29] This was the first widely used vaccine that was made in a laboratory.[16] Later use showed this early cholera vaccine to be ineffective.[30]

Louis Pasteur

In 1884, Spanish physician developed a live vaccine he had isolated from cholera patients in Marseilles, and used it that on over 30,000 individuals in Valencia during that year's epidemic. However, his vaccine and inoculation was rather controversial and was rejected by his peers and several investigation commissions,[31] but it ended up demonstrating its effectiveness and being recognized for it.[32]

Jaume Ferran i Clua

In 1892, developed an effective vaccine with less severe side effects, later testing it on more than 40,000 people in the Calcutta area from 1893 to 1896.[33] His vaccine was accepted by the medical community, and is credited as the first effective human cholera vaccine.[31][34][35][36]

Waldemar Haffkine

Finally, in 1896, introduced a heat-killed vaccine that was significantly easier to prepare than Haffkine's, using it on a large scale in Japan in 1902.[37]

Wilhelm Kolle

The first cholera vaccines were developed in the late 19th century. There were several pioneers in the development of the vaccine:


Oral cholera vaccines were first introduced in the 1990s.[10]

Society and culture[edit]

Legal status[edit]

In 2016, the US Food and Drug Administration (FDA) approved Vaxchora,[15][14][27] a single-dose oral vaccine to prevent cholera for travelers. As of June 2016, Vaxchora is the only FDA-approved vaccine for the prevention of cholera.[27]

Economics[edit]

The cost to immunize against cholera is between US$0.10 and $4.00 per vaccination.[38]


The Vaxchora vaccine can cost more than $250.[39]

. U.S. Centers for Disease Control and Prevention (CDC). October 2019.

"Cholera Vaccine Information Statement"

at the U.S. National Library of Medicine Medical Subject Headings (MeSH)

Cholera Vaccines