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Oral killed cholera vaccines for preventing cholera
K M Saif-Ur-Rahman1,2,3, Razib Mamun4, Md Hasan5,6
1Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh.
The Cochrane Database of Systematic Reviews
|January 10, 2024
Summary
Oral killed cholera vaccines, including Dukoral and Shanchol, significantly reduce cholera cases in children and adults. These WHO-prequalified vaccines are safe and well-tolerated, offering effective protection against cholera outbreaks.
Area of Science:
- Public Health
- Infectious Diseases
- Vaccinology
Background:
- Cholera outbreaks disproportionately affect areas with poor sanitation, necessitating effective preventative measures.
- Oral killed cholera vaccines have been developed over the past 50 years to combat this disease.
- This review focuses on WHO-prequalified oral killed cholera vaccines, updating previous analyses.
Approach:
- Systematic review and meta-analysis of randomized controlled trials (RCTs), including cluster-RCTs.
- Inclusion of studies on WHO-prequalified oral killed cholera vaccines regardless of participant age or setting.
- Assessment of vaccine effectiveness and safety using GRADE and Cochrane ROB 1 tools.
Key Points:
- Two doses of Dukoral demonstrated 76% vaccine effectiveness (VE) against cholera at two-year follow-up (high-certainty evidence).
- Two doses of Shanchol showed 37% VE at one year and 64% VE at two years (high and moderate-certainty evidence, respectively).
- A single dose of Shanchol provided 40% VE at six months and 39% VE at two years (high-certainty evidence).
Conclusions:
- Both Dukoral and Shanchol are effective in reducing cholera cases, with varying effectiveness over time and doses.
- Oral killed cholera vaccines are safe and well-tolerated, with no significant differences in adverse events reported compared to placebo.
- Findings for Shanchol are applicable to other Bivalent Whole-Cell (BivWC) vaccines like Euvichol/Euvichol-Plus due to comparable vibriocidal responses.
