Cholera vaccine

A cholera vaccine is a vaccine that is effective at preventing cholera. The currently recommended cholera vaccines are administered orally to elicit a protective local mucosal immune response in the gut, which 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 percent protection, which decreases to aproximately 60 percent during the first two years. 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 percent (known as herd immunity).

The World Health Organization (WHO) currently 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. Two vaccine doses with a 1-6 week interval are typically recommended. The duration of protection is at least two years in adults and six months in children aged 1–5 years. 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.

The available types of oral vaccine are generally safe. Mild abdominal pain or diarrhea may occur. They are safe in pregnancy and in those with poor immune function. They are licensed for use in more than 60 countries. In countries where the disease is common, the vaccine appears to be cost effective.

The first cholera vaccines were developed in the late 19th century. 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 .

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