WC-rBS (marketed as "Dukoral") is a monovalent inactivated vaccine containing killed whole cells of V. cholerae O1 plus additional recombinant cholera toxin B subunit. BivWC (marketed as "Shanchol" and "mORCVAX") is a bivalent inactivated vaccine containing killed whole cells of V. cholerae O1 and V. cholerae O139. mORCVAX is only available in Vietnam. Bacterial strains of both Inaba and Ogawa serotypes and of El Tor and Classical biotypes are included in the vaccine. Dukoral is taken orally with bicarbonate buffer, which protects the antigens from the gastric acid. The vaccine acts by inducing antibodies against both the bacterial components and CTB. The antibacterial intestinal antibodies prevent the bacteria from attaching to the intestinal wall, thereby impeding colonisation of V. cholerae O1. The anti-toxin intestinal antibodies prevent the cholera toxin from binding to the intestinal mucosal surface, thereby preventing the toxin-mediated diarrhoeal symptoms.A live, attenuated oral vaccine (CVD 103-HgR or Vaxchora), derived from a serogroup O1 classical Inaba strain, was approved by the US FDA in 2016. Injectable
Although rarely in use, the injected cholera vaccines are effective for people living where cholera is common. They offer some degree of protection for up to two years after a single shot, and for three to four years with annual booster. They reduce the risk of death from cholera by 50 percent in the first year after vaccination. Side effects
Both of 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.
As of June 2016, Vaxchora was the only FDA-approved vaccine for the prevention of cholera. The Vaxchora vaccine can cost more than US$250. References
Further reading
World Health Organization (2010). The immunological basis for immunization series: module 14: cholera. World Health Organization (WHO). hdl:10665/44367. ISBN 9789241599740. Ramsay M, ed. (2013). "Chapter 14: Cholera". Immunisation against infectious disease. Public Health England. Centers for Disease Control and Prevention (2017). "Cholera". CDC Yellow Book 2020: Health Information for International Travel. New York: Oxford University Press. Cholera and enterotoxigenic escherichia coli (ETEC) travellers diarrhea vaccine: Canadian Immunization Guide. Health Canada (Report). External links
"Cholera Vaccine Information Statement". Centers for Disease Control and Prevention (CDC). 23 October 2019. Cholera Vaccines at the US National Library of Medicine Medical Subject Headings (MeSH)