They are licensed for use in more than 60 countries. In countries where the disease is common, the vaccine appears to be cost effective. History of development
The first vaccines used against cholera were developed in the late 19th century. There were several pioneers in the development of the vaccine. The first cholera vaccine developed by Louis Pasteur was on chicken and other animals. They were the first widely used vaccine that was made in a laboratory. In 1884, Spanish physician Jaume Ferran i Clua developed a live vaccine he had isolated from cholera patients in Marseilles, and used it that on over 30,000 individuals in Valencia during that years epidemic. However, his vaccine and inoculation was rather controversial and was rejected by his peers and several investigation commissions. In 1892, Waldemar Haffkine developed an effective vaccine with less severe side effects, later testing it on more than 40,000 people in the Calcutta area from 1893 to 1896. His vaccine was accepted by the medical community, and is credited as the first effective human cholera vaccine. Finally, in 1896, Wilhelm Kolle introduced a heat-killed vaccine that was significantly easier to prepare than Haffkines, using it on a large scale in Japan in 1902.Oral cholera vaccines were first introduced in the 1990s. The cost to immunize against cholera is between US$0.10 and US$4.00 per vaccination.In 2016, the U.S. Food and Drug Administration (FDA) approved Vaxchora, a single-dose oral vaccine to prevent cholera for travelers.
The administration of the vaccine to adults confers additional indirect protection (herd immunity) to children. The World Health Organization (WHO) recommends both preventive and reactive use of the vaccine, making the following key statements:
WHO recommends that current available cholera vaccines be used as complements to traditional control and preventive measures in areas where the disease is endemic and should be considered in areas at risk for outbreaks. Vaccination should not disrupt the provision of other high priority health interventions to control or prevent cholera outbreaks.... Reactive vaccination might be considered in view of limiting the extent of large prolonged outbreaks, provided the local infrastructure allows it, and an in-depth analysis of past cholera data and identification of a defined target area have been performed. The WHO as of late 2013 established a revolving stockpile of two million OCV doses. The supply is increasing to six million as a South Korean companies has gone into production (2016), the old production not being able to handle WHO demand in Haiti and Sudan for 2015, nor prior years. GAVI Alliance donated $115 million to help pay for expansions. Oral
The oral vaccines are generally of two forms: inactivated and attenuated. Inactivated oral vaccines provide protection in 52 percent of cases the first year following vaccination and in 62 percent of cases the second year. Two variants of the inactivated oral vaccine currently are in use: WC-rBS and BivWC.