Feasibility, coverage and cost of oral cholera vaccination conducted by icddr,b using the existing national immunization service delivery mechanism in rural setting Keraniganj, Bangladesh

Abstract

Background : Cholera is a considerable health burden in developing country settings including Bangladesh. The oral cholera vaccine (OCV) is a preventative tool to control the disease. The objective of this study was to describe whether the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), could provide the OCV to rural communities using existing government infrastructure. Methods : The study was conducted in rural sub-district Keraniganj, 20 km from the capital city Dhaka. All listed participants one year and above in age (excluding pregnant women) were offered two doses of OCV at a 14 day interval. Existing government facilities were used to deliver and also maintain the cold chain required for the vaccine. All events related to vaccination were recorded at the 17 vaccination sites to evaluate the coverage and feasibility of OCV program. Results : A total of 29,029 individuals received the 1st dose (90% of target) and 26,611 individuals received the 2nd dose (83% of target and 92% of 1st dose individuals) of OCV. The highest vaccination coverage was in younger children (1–9 years) and the lowest was amongst 18–29-year age group. Somewhat better coverage was seen amongst the female participants than males (92% vs. 88% for the 1st dose and 93% vs. 90% for the 2nd dose). The cost of vaccine cost was calculated as US$1.00 per dose plus freight, insurance, and transportation and the total vaccine delivery cost was US$70,957. Conclusion : This was a project undertaken using existing public health program resources to collect empirical evidence on the use of a mass OCV campaign in the rural setting. Mass vaccination with the OCV is feasible in the rural setting using existing governmental vaccine delivery systems in Bangladesh.

Controlled Human Infection Models To Accelerate Vaccine Development

“…The outbreaks in Haiti and Yemen affected 5 percent of each country's population. Three internationally licensed cholera vaccines and three other cholera vaccines licensed for a limited geographic region or for use in a single country are currently available, and have been used in several mass vaccination campaigns in Haiti, Bangladesh, Iraq, and at least nine countries in sub-Saharan Africa (216,239). Epidemiological modeling suggests that even modest coverage with vaccines akin to those already available, combined with herd immunity, could lead to major reductions in the numbers of cholera cases in communities where vaccination is provided, including among young children who are ineligible for vaccination.…”

Use of surveys to evaluate an integrated oral cholera vaccine campaign in response to a cholera outbreak in Hoima district, Uganda

“…Most other OCV campaigns have also reported high coverage rates. These have included reports from Bangladesh, 23 24 Malawi, 25 26 Mozambique, 21 DRC, 27 Zambia, 28 South Sudan, 29 30 Iraq, 31 Haiti 32 and Guinea. 33 Clearly, OCV is well accepted among these very diverse population groups where the vaccine campaigns have been carried out.…”

Vaccines for enteric diseases

“…In this issue. Khan et al 52 assessed the feasibility of using the existing government infrastructure to provide oral cholera vaccine to residents in rural communities in Bangladesh. They demonstrated high vaccine coverage for the first and second vaccine doses of 90% and 83%, respectively.…”

“…They demonstrated high vaccine coverage for the first and second vaccine doses of 90% and 83%, respectively. 52 Interestingly, an oral live-attenuated vaccine CVD 103-HgR (VAXCHORA™) given in a single dose was licensed by the US FDA for US travelers to areas of ongoing cholera transmission. The vaccine was well-tolerated and provided high efficacy (90%) which was evident 10 days postvaccination in a human challenge study.…”