Infection and drug resistance · 2026
Oral Cholera Vaccines as Transmission-Interrupting Tools for Cholera Control: A Narrative Review.
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Bateyi Mustafa Stéphane-Hans, Patrick Tambwe, Raoul Raha Zihindula, Dominique Bigabwa Baharanyi
Аннотация
BACKGROUND: Cholera remains a significant global health challenge, with an estimated 1.3 billion people at risk in endemic regions and recurrent outbreaks increasingly reported in fragile, conflict-affected, and humanitarian settings. Persistent transmission continues despite advances in case management and water, sanitation, and hygiene (WASH) interventions.
OBJECTIVE: To synthesize current evidence on oral cholera vaccines (OCVs) as transmission-interrupting tools and to examine their implications for integrated cholera control strategies.
METHODS: This narrative review synthesized published evidence on oral cholera vaccines (OCVs) and their role in interrupting cholera transmission. A literature search was conducted in PubMed, Scopus, Web of Science, Embase, Google Scholar, and relevant World Health Organization (WHO) and Global Task Force on Cholera Control (GTFCC) publications. Studies published between January 2000 and February 2026 were considered. Eligible sources included systematic reviews, randomized controlled trials, observational studies, outbreak investigations, mathematical modeling studies, and international policy documents addressing vaccine effectiveness, herd protection, transmission dynamics, operational deployment, and integration with Water, Sanitation and Hygiene (WASH) interventions. Evidence was narratively synthesized according to major thematic areas.
RESULTS: Two-dose killed whole-cell OCVs provide 66-81% protection at six months post-vaccination. Empirical evidence and modeling studies demonstrate substantial herd protection when coverage exceeds 50-70%, with projected overall incidence reductions exceeding 75% in certain endemic contexts. Reactive campaigns implemented within the first week of outbreak detection can avert up to 70% of cases, although effectiveness declines rapidly with delayed deployment. Single-dose regimens provide moderate short-term protection but exhibit faster waning. Impact is context-dependent and influenced by baseline immunity, surveillance quality, and concurrent WASH interventions.
CONCLUSION: OCVs function most effectively as transmission-interrupting tools when deployed rapidly, targeted strategically, and integrated with WASH, surveillance, and community engagement. While not a substitute for structural prevention, vaccination represents a critical catalytic intervention within comprehensive cholera control and elimination frameworks.
OBJECTIVE: To synthesize current evidence on oral cholera vaccines (OCVs) as transmission-interrupting tools and to examine their implications for integrated cholera control strategies.
METHODS: This narrative review synthesized published evidence on oral cholera vaccines (OCVs) and their role in interrupting cholera transmission. A literature search was conducted in PubMed, Scopus, Web of Science, Embase, Google Scholar, and relevant World Health Organization (WHO) and Global Task Force on Cholera Control (GTFCC) publications. Studies published between January 2000 and February 2026 were considered. Eligible sources included systematic reviews, randomized controlled trials, observational studies, outbreak investigations, mathematical modeling studies, and international policy documents addressing vaccine effectiveness, herd protection, transmission dynamics, operational deployment, and integration with Water, Sanitation and Hygiene (WASH) interventions. Evidence was narratively synthesized according to major thematic areas.
RESULTS: Two-dose killed whole-cell OCVs provide 66-81% protection at six months post-vaccination. Empirical evidence and modeling studies demonstrate substantial herd protection when coverage exceeds 50-70%, with projected overall incidence reductions exceeding 75% in certain endemic contexts. Reactive campaigns implemented within the first week of outbreak detection can avert up to 70% of cases, although effectiveness declines rapidly with delayed deployment. Single-dose regimens provide moderate short-term protection but exhibit faster waning. Impact is context-dependent and influenced by baseline immunity, surveillance quality, and concurrent WASH interventions.
CONCLUSION: OCVs function most effectively as transmission-interrupting tools when deployed rapidly, targeted strategically, and integrated with WASH, surveillance, and community engagement. While not a substitute for structural prevention, vaccination represents a critical catalytic intervention within comprehensive cholera control and elimination frameworks.