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Oral Cholera Vaccines as Transmission-Interrupting Tools for Cholera Control: A Narrative Review
Stéphane-Hans Bateyi Mustafa1,2, Tambwe Patrick3, Raha Zihindula Raoul4
1Department of Public Health, Free University of the Great Lakes Countries (ULPGL), Goma, Democratic Republic of Congo.
Oral cholera vaccines (OCVs) offer significant protection against cholera, with two-dose regimens providing up to 81% efficacy. When integrated with WASH interventions, OCVs are crucial for cholera control and elimination efforts.
Area of Science:
- Global Health
- Vaccinology
- Infectious Disease Epidemiology
Background:
- Cholera poses a substantial global health risk, affecting 1.3 billion people and frequently causing outbreaks in vulnerable settings.
- Despite advancements in case management and WASH interventions, cholera transmission persists.
Purpose of the Study:
- To review existing evidence on the effectiveness of oral cholera vaccines (OCVs) as tools to interrupt disease transmission.
- To analyze the role of OCVs within broader cholera control strategies.
Main Methods:
- A comprehensive literature search was conducted across major scientific databases and WHO/GTFCC publications.
- Included studies published between 2000 and 2026, encompassing various study designs and policy documents.
- Evidence was synthesized narratively, focusing on vaccine effectiveness, herd protection, and integration with WASH.
Main Results:
- Two-dose OCVs provide 66-81% protection for six months; substantial herd protection is observed with >50-70% coverage.
- Reactive vaccination campaigns can avert up to 70% of cases if deployed within one week of outbreak detection.
- Single-dose OCVs offer moderate short-term protection with faster waning; impact is context-dependent.
Conclusions:
- OCVs are most effective when rapidly deployed, strategically targeted, and integrated with WASH, surveillance, and community engagement.
- Vaccination serves as a vital catalytic intervention, complementing structural prevention for cholera control and elimination.
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