Geneva — The World Health Organization announced on Wednesday that a shortage of cholera vaccines has necessitated a temporary shift to a one-dose strategy, as opposed to the typical two doses, in campaigns to combat an increasing number of outbreaks. The United Nations health agency stated that the International Coordinating Group (ICG), which controls emergency vaccine supplies, was compelled to halt the two-dose regimen due to a “strained worldwide supply of cholera vaccinations.”
“The shift in strategy will allow the dosages to be used in more countries at a time when cholera outbreaks are increasing at an unprecedented rate,” WHO said in a statement.
Cholera is an acute infection of the small intestine that causes dehydration that can be lethal. Cholera is typically contracted via consuming contaminated food or water with vibrio cholera germs.
Cholera is rapidly spreading
Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, informed reporters that “29 countries have reported outbreaks this year, including 13 nations that did not have outbreaks last year.”
This is in contrast to the fewer than 20 nations that reported such epidemics during the preceding five years.
Due to floods, droughts, violence, population movements, and other circumstances that limit access to clean water and increase the risk of cholera epidemics, the global trend is towards more frequent, extensive, and severe outbreaks, according to a statement released on Wednesday.
Kenya is the most recent country to announce a cholera outbreak, with at least 61 confirmed cases as of Thursday, according to Kenyan officials.
On October 7, 2022, a youngster with cholera symptoms is treated at a facility operated by Doctors Without Borders (MSF) in Port-au-Prince, Haiti. Odelyn Joseph/AP
In Haiti, where a political and security crisis has allowed one of the world’s most lethal cholera outbreaks to spread, at least 606 suspected and 66 confirmed cases were confirmed by the health ministry on Tuesday, according to data acquired by AFP.
Between October 13 and October 17, 222 new suspected cases were reported in an outbreak previously attributed to at least 22 deaths. New regions of the impoverished Caribbean country have recently reported suspected cases of the disease.
A “last-resort decision”
WHO and other members of the ICG, including Doctors Without Borders (MSF), UNICEF, and the Red Cross, emphasized that a one-dose method for cholera vaccinations had been shown to be effective in responding to outbreaks. However, they cautioned that there was scant information regarding the exact length of protection, which appeared to be substantially shorter in children.
With two doses, when the second dose is administered within six months of the first, the duration of protection against infection is three years.
The letter warned that the present supply of cholera vaccines was “very limited” and stated, “The value of providing one dosage still surpasses none.”
A pupil takes an oral dose of cholera vaccine from a health worker during a vaccination program on June 6, 2022 in Dhaka, Bangladesh. Sazzad Hossain/SOPA Images/LightRocket/Getty
ICG manages a global stockpile of oral cholera vaccines, but 24 million doses of the 36 million doses anticipated to be produced this year have already been distributed for preventative and reactive campaigns.
ICG has also approved eight million more pills for a second round of emergency vaccination in four countries.
Tedros stated that the adjustment in tactics was “obviously suboptimal, and rationing must be a temporary solution.”
During a vaccination campaign on June 8, 2022 in Dhaka, Bangladesh, oral cholera vaccine doses are observed. Photograph by Sazzad Hossain/SOPA Images/LightRocket/Getty
Shanchol, an Indian subsidiary of the French pharmaceutical behemoth Sanofi, has announced that it will cease production of one of only two cholera vaccines approved for use in humanitarian emergencies by the end of the year. This is one of the factors contributing to the growing concern over the situation. A spokesperson for Sanofi emphasized, however, that the vaccine scarcity was not due to a halt in vaccine manufacture by Sanofi, since the company continues to provide doses of Shanchol.
Due to the limited number of doses it was generating and the fact that other actors had declared plans to boost capacity, the business had indicated its intention to cease production in 2020.
MSF stated that the urgent global shortage of cholera vaccinations forced it and other ICG members to support the “very difficult decision” of decreasing the number of doses from two to one.
“It is tremendously disheartening to face this situation as cholera spreads across more than 20 countries, including already-devastated nations like Haiti, Nigeria, and Syria,” said Daniela Garone, MSF’s international medical coordinator. This option is the only way to avoid having to choose between sending doses to one country or another.