Lessons learned from the deployment of oral cholera vaccine by maintaining the controlled temperature chain (CTC) in an urban setting, Bangladesh.

Cholera, caused by Vibrio cholerae, remains a significant public health issue, especially in regions prone to outbreaks. While the oral cholera vaccine (OCV) is an effective preventive tool, its use is often limited by the traditional cold chain requirements. The controlled temperature chain (CTC) provides an alternative by allowing vaccines to be stored at ambient temperatures for limited periods. This study explored participants' hands-on experiences with CTC compared with standard cold chain (SCC). This qualitative study during the March 2024 OCV campaign in Dhaka, Bangladesh, used purposive sampling, including six in-depth interviews (IDIs) with volunteers and four key informant interviews (KIIs) with policymakers. Volunteers were selected from two groups (Group A: SCC, and Group B: CTC) based on their vaccination, supervision, and record-keeping roles, while the policymakers were involved in planning during campaign deployment. The interviews observed frontline experiences and expert opinions on the feasibility, appropriateness, and logistical difficulties of both approaches. Compared to the SCC, the CTC strategy provided operational advantages, including reduced transportation costs, decreased refrigeration dependency, and easier management in the hard-to-reach areas. Participants highlighted that the vaccines could be stored at ambient temperatures for up to 14 d under CTC, enabling extended deployment with minimal wastage. Overall, the participants perceived the CTC strategy as more competent in vaccine deployment, requiring fewer resources. For improving vaccine deployment strategies in cholera prevention, this study provided practical insights by using the CTC approach.