Cholera: WHO approves simplified version of oral vaccine to address shortages

The need is “urgent”. WHO has approved a simplified version of the oral cholera vaccine, which should allow the overall production of these sera to be increased in the face of a sharp rise in incidence worldwide.

The Evichol-S vaccine is a simplified formulation of Evichol-Plus with fewer components, which will allow for faster production in larger volumes, the World Health Organization said in a statement on Friday. It is produced by the South Korean group EuBiologics, whose WHO has already approved the Euvichol and Euvichol-Plus vaccines.

According to the organization, the new vaccine has a level of effectiveness similar to more complex formulations. “The new vaccine is the third product from the same family of cholera vaccines on our prequalification list,” said Rogerio Gaspar, Director of WHO’s Department of Regulatory Affairs and Prequalification. He hopes for “rapid growth in production and supplies, which are desperately needed by many communities battling cholera outbreaks.”

23 countries in epidemic

Cholera, which can be contracted from bacteria usually transmitted through contaminated water or food, causes diarrhea and vomiting and can be dangerous to young children. The number of cases worldwide has risen in recent years, with 473,000 cases reported to WHO in 2022, double the number the year before, and preliminary data showing more than 700,000 cases were reported last year.

Although the global supply of cholera vaccines increased 18-fold between 2013 and 2023, rising demand has led to global shortages. Currently, 23 countries are reporting cholera outbreaks. The most severe impacts are being felt in the Comoros, Democratic Republic of the Congo, Ethiopia, Mozambique, Somalia, Zambia and Zimbabwe. To cope with the sharp increase in cases, the WHO has abandoned its recommendation of two doses of the vaccine instead of one.

The WHO green light will help increase global supplies from 38 million doses in 2023 to about 50 million this year, according to the Vaccine Alliance (GAVI) and UNICEF, the UN children’s agency. The WHO decision “represents a lifeline for vulnerable communities around the world,” said Derrick Sim, head of vaccine markets at GAVI. The liquid vaccine has a shelf life of 24 months.

EuBiologics is currently the only supplier of oral cholera vaccines, although other manufacturers are expected to offer products in the coming years.