Evidence is mounting that oral vaccines against cholera can stem the spread of the disease, even when they are given at the start of an epidemic, according to a Weill Cornell Medical College physician.
New research shows that after two doses, the vaccine protects against cholera more than 86 percent of the time. While the finding reinforces a World Health Organization promotion of the vaccine during cholera outbreaks, public health practitioners still face a shortage of affordable doses, among other challenges, Dr. Jean Pape writes in an accompanying commentary in the May 29 issue of the New England Journal of Medicine.
“The world will need millions more doses," according to Dr. Pape and his co-author, Dr. Vanessa Rouzier. Dr. Pape is a professor of medicine at Weill Cornell who directs GHESKIO, a health center in Haiti that specializes in infectious disease.
Scientists must answer other questions before health care providers can use the vaccines most effectively, they write. Would one dose, which is cheaper and easier to administer, work as effectively as two? How well does it work when it's stored at room temperature, rather than refrigerated? Can pregnant women and children under a year old safely take it?
Still, while so-called WASH practices—water, sanitation and hygiene—are the first-line methods of preventing cholera, the three oral cholera vaccines on the market can protect against the illness, especially in settings where people lack soap and clean water, Drs. Pape and Rouzier write.