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Cholera immunisation

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Take expert advice - for example, from the Bureau of Hygiene and Tropical Medicine, London.

  • prevention of cholera depends primarily on improving sanitation and water supplies in endemic areas and on scrupulous personal and food and water hygiene. While new oral cholera vaccines can provide individual protection against V. cholerae O1, their role in endemic and outbreak conditions is not yet defined
  • the only cholera vaccine licensed in the UK since May 2004 is Dukoral®, a killed V. cholerae whole-cell (WC) vaccine with recombinant B subunit of cholera toxin (rCTB), administered orally. Intramuscular cholera vaccines are no longer recommended for use.
  • only three oral vaccines are pre-qualified by the World Health Organization (WHO) for the prevention of cholera: Dukoral®, Shanchol®, and Euvichol®.

Note however that Dukoral is an oral, killed recombinant B-subunit/whole-cell cholera vaccine (BS/WC)

  • Dukoral has been licensed in Sweden since 1991
  • Dukaral is the only cholera vaccine licensed in the UK since May 2004
  • the BS/WC vaccine is indicated for active immunisation against disease caused by Vibrio cholerae serogroup O1 in adults and children from 2 years of age who will be visiting endemic/epidemic areas
  • this is the only cholera vaccine currently recommended by the WHO for the pre-emptive vaccination of populations at immediate risk of a cholera epidemic (1)
  • intramuscular cholera vaccines are no longer recommended for use (2)

Reference:

  1. UK Health Security Agency. Cholera: the green book, chapter 14. Cholera immunisation information for public health professionals. Published March 2013, last updated August 2024
  2. Graves PM, Deeks JJ, Demicheli V, et al. Vaccines for preventing cholera: killed whole cell or other subunit vaccines (injected). Cochrane Database Syst Rev. 2010 Aug 4;(8):CD000974.

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