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Experts urge US to create emergency cholera vaccine stockpile for humanitarian use
Date:11/24/2010

Since 1991, Dukoral has been licensed in more than 60 countries, and is prequalified by the WHO for purchase by United Nations agencies. It has been used in crisis situations in Indonesia, Sudan, and Uganda, as well as in densely populated urban slums in Mozambique. The two other vaccines -- Shanchol produced by Shantha Biotechnics of India, and mORC-VAX made by VaBiotech in Vietnam -- consist of killed V. cholerae cells without the added toxin. Both vaccines were licensed in 2009, and Shanchol is currently awaiting prequalification by the WHO. All three vaccines are administered in a two-dose regimen.

Notably, the licensing in India of Shanchol, which was originally developed by the IVI, has added considerably to the momentum for the use of oral cholera vaccines to control endemic and epidemic cholera due to the numerous advantages it confers. Unlike Dukoral, it does not require administration with a buffer, thereby greatly simplifying its use under field conditions, including refugee camps and other post-crisis situations. In addition, it is a low-cost vaccine, increasing its access to governments and international agencies. Finally, a large efficacy trial in India has shown that the vaccine is more effective and lasts longer in young children (1-5 years old) than Dukoral. Of critical importance, the WHO's Strategic Advisory Group of Experts (SAGE) issued new updated recommendations for the use of new-generation cholera vaccines in its position paper in March 2010.

Alarmingly, however, fewer than 500,000 total doses of oral cholera vaccines (Dukoral or Shanchol) are presently available for shipment from their manufacturers, making it impossible to consider large-scale vaccination of at-risk populations. "The global shortage of cholera vaccine reinforces the urgency of creating a stockpile," said Dr. Clemens, an international expert in vaccine evaluation for developing countries.

Even though there is no imminent threat of cholera in
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Contact: Tae Kyung Byun
tkbyun@ivi.int
822-881-1159
International Vaccine Institute
Source:Eurekalert

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