Achievements and challenges for the use of killed oral cholera vaccines in the global stockpile era

Desai, Sachin N.; Pezzoli, Lorenzo; Alberti, Kathryn P.; Martin, Stephen J.; Costa, Alejandro; Perea, William; Legros, Dominique

doi:10.1080/21645515.2016.1245250

Cited by 36 publications

(22 citation statements)

References 51 publications

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“…outbreak response or humanitarian crisis) is managed by the International Coordinating Group (ICG), composed by Médecins Sans Frontières (MSF), the International Federation of Red Cross/Crescent (IFRC), Unicef, and the WHO; while the allocation of OCV in non-emergency (i.e. vaccination in cholera endemic “hotspots”) is coordinated by the Global Task Force on Cholera Control (GTFCC), a WHO coordinated network of partners active in controlling cholera [ 9 ]. According to the last WHO’s report, since creation of the stockpile, as of April 2017, almost 8 million doses of OCV have been shipped for the implementation of more than 40 OCV vaccination campaigns in 14 countries [ 10 ] including Cameroon, Democratic Republic of the Congo, Ethiopia, Guinea, Haïti, Iraq, Malawi, Niger, South Sudan and Zambia [ 11 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

Oral cholera vaccine coverage during a preventive door-to-door mass vaccination campaign in Nampula, Mozambique

et al. 2018

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BackgroundIn addition to improving water, sanitation and hygiene (WASH) measures and optimal case management, the introduction of Oral cholera vaccine (OCV) is a complementary strategy for cholera prevention and control for vulnerable population groups. In October 2016, the Mozambique Ministry of Health implemented a mass vaccination campaign using a two-dose regimen of the Shanchol™ OCV in six high-risk neighborhoods of Nampula city, in Northern Mozambique. Overall 193,403 people were targeted by the campaign, which used a door-to-door strategy. During campaign follow-up, a population survey was conducted to assess: (1) OCV coverage; (2) frequency of adverse events following immunization; (3) vaccine acceptability and (4) reasons for non-vaccination.Methodology/Principal findingsIn the absence of a household listing and clear administrative neighborhood delimitations, we used geospatial technology to select households from satellite images and used the support of community leaders. One person per household was randomly selected for interview. In total, 636 individuals were enrolled in the survey. The overall vaccination coverage with at least one dose (including card and oral reporting) was 69.5% (95%CI: 51.2–88.2) and the two-dose coverage was 51.2% (95%CI: 37.9–64.3). The campaign was well accepted. Among the 185 non-vaccinated individuals, 83 (44.6%) did not take the vaccine because they were absent when the vaccination team visited their houses. Among the 451 vaccinated individuals, 47 (10%) reported minor and non-specific complaints, and 78 (17.3%) mentioned they did not receive any information before the campaign.Conclusions/SignificanceIn spite of overall coverage being slightly lower than expected, the use of a mobile door-to-door strategy remains a viable option even in densely-populated urban settings. Our results suggest that campaigns can be successfully implemented and well accepted in Mozambique in non-emergency contexts in order to prevent cholera outbreaks. These findings are encouraging and complement the previous Mozambican experience related to OCV.

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Section: Introductionmentioning

confidence: 99%

Oral cholera vaccine coverage during a preventive door-to-door mass vaccination campaign in Nampula, Mozambique

et al. 2018

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“…As a consequence, there has been an increased enthusiasm in its use for the prevention of cholera. A review from the WHO reported that up to 35 OCV campaigns were conducted between July 2013 to July 2016 in response to emergency and endemic contexts in various settings [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Delivery cost analysis of a reactive mass cholera vaccination campaign: a case study of Shanchol™ vaccine use in Lake Chilwa, Malawi

Ilboudo

Gargasson

2017

BMC Infect Dis

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BackgroundCholera is a diarrheal disease that produces rapid dehydration. The infection is a significant cause of mortality and morbidity. Oral cholera vaccine (OCV) has been propagated for the prevention of cholera. Evidence on OCV delivery cost is insufficient in the African context. This study aims to analyze Shanchol vaccine delivery costs, focusing on the vaccination campaign in response of a cholera outbreak in Lake Chilwa, Malawi.MethodsThe vaccination campaign was implemented in two rounds in February and March 2016. Structured questionnaires were used to collect costs incurred for each vaccination related activity, including vaccine procurement and shipment, training, microplanning, sensitization, social mobilization and vaccination rounds. Costs collected, including financial and economic costs were analyzed using Choltool, a standardized cholera cost calculator.ResultsIn total, 67,240 persons received two complete doses of the vaccine. Vaccine coverage was higher in the first round than in the second. The two-dose coverage measured with the immunization card was estimated at 58%. The total financial cost incurred in implementing the campaign was US$480275 while the economic cost was US$588637. The total financial and economic costs per fully vaccinated person were US$7.14 and US$8.75, respectively, with delivery costs amounting to US$1.94 and US$3.55, respectively. Vaccine procurement and shipment accounted respectively for 73% and 59% of total financial and economic costs of the total vaccination campaign costs while the incurred personnel cost accounted for 13% and 29% of total financial and economic costs. Cost for delivering a single dose of Shanchol was estimated at US$0.97.ConclusionThis study provides new evidence on economic and financial costs of a reactive campaign implemented by international partners in collaboration with MoH. It shows that involvement of international partners’ personnel may represent a substantial share of campaign’s costs, affecting unit and vaccine delivery costs.Electronic supplementary materialThe online version of this article (10.1186/s12879-017-2885-8) contains supplementary material, which is available to authorized users.

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“…The vaccine has most often been given in two doses, 14 days apart, as recommended by the manufacturers. 9 Yet giving a second dose of OCV on schedule can be challenging during crisis situations. Furthermore, multiple competing demands on the global stockpile mean that, at times, officials might have to decide if they should vaccinate a population without guarantee of the availability of the second tranche of doses.…”

Section: Cholera Control: One Dose At a Timementioning

confidence: 99%

Cholera control: one dose at a time

Ivers

2018

The Lancet Infectious Diseases

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Achievements and challenges for the use of killed oral cholera vaccines in the global stockpile era

Cited by 36 publications

References 51 publications

Oral cholera vaccine coverage during a preventive door-to-door mass vaccination campaign in Nampula, Mozambique

Oral cholera vaccine coverage during a preventive door-to-door mass vaccination campaign in Nampula, Mozambique

Delivery cost analysis of a reactive mass cholera vaccination campaign: a case study of Shanchol™ vaccine use in Lake Chilwa, Malawi

Cholera control: one dose at a time

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