Oral Cholera Vaccine Development and Use in Vietnam

Anh, Đặng Đức; Lopez, Anna Lena; Tran, Hung Thi Mai; Cương, Nguyễn Văn; Thiem, Vu Dinh; Ali, Mohammad; Deen, Jacqueline; Seidlein, Lorenz von; Sack, David A.

doi:10.1371/journal.pmed.1001712

Cited by 22 publications

(17 citation statements)

References 19 publications

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“…This vaccine received World Health Organization (WHO) prequalification in 2001 and has a price of $5 per dose on the public market. Meanwhile, Vietnam developed and deployed a locally manufactured OCV, ORC-Vax [8]. The vaccine was licensed in 1997 in Vietnam and was modified to mORC-Vax in 2009 after improving the production process.…”

Section: Introductionmentioning

confidence: 99%

Oral Cholera Vaccination Delivery Cost in Low- and Middle-Income Countries: An Analysis Based on Systematic Review

et al. 2016

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BackgroundUse of the oral cholera vaccine (OCV) is a vital short-term strategy to control cholera in endemic areas with poor water and sanitation infrastructure. Identifying, estimating, and categorizing the delivery costs of OCV campaigns are useful in analyzing cost-effectiveness, understanding vaccine affordability, and in planning and decision making by program managers and policy makers.ObjectivesTo review and re-estimate oral cholera vaccination program costs and propose a new standardized categorization that can help in collation, analysis, and comparison of delivery costs across countries.Data sourcesPeer reviewed publications listed in PubMed database, Google Scholar and World Health Organization (WHO) websites and unpublished data from organizations involved in oral cholera vaccination.Study eligibility criteriaThe publications and reports containing oral cholera vaccination delivery costs, conducted in low- and middle-income countries based on World Bank Classification. Limits are humans and publication date before December 31st, 2014.ParticipantsNo participants are involved, only costs are collected.InterventionOral cholera vaccination and cost estimation.Study appraisal and synthesis methodA systematic review was conducted using pre-defined inclusion and exclusion criteria. Cost items were categorized into four main cost groups: vaccination program preparation, vaccine administration, adverse events following immunization and vaccine procurement; the first three groups constituting the vaccine delivery costs. The costs were re-estimated in 2014 US dollars (US$) and in international dollar (I$).ResultsTen studies were identified and included in the analysis. The vaccine delivery costs ranged from US$0.36 to US$ 6.32 (in US$2014) which was equivalent to I$ 0.99 to I$ 16.81 (in I$2014). The vaccine procurement costs ranged from US$ 0.29 to US$ 29.70 (in US$2014), which was equivalent to I$ 0.72 to I$ 78.96 (in I$2014). The delivery costs in routine immunization systems were lowest from US$ 0.36 (in US$2014) equivalent to I$ 0.99 (in I$2014).LimitationsThe reported cost categories are not standardized at collection point and may lead to misclassification. Costs for some OCV campaigns are not available and analysis does not include direct and indirect costs to vaccine recipients.Conclusions and implications of key findingsVaccine delivery cost estimation is needed for budgeting and economic analysis of vaccination programs. The cost categorization methodology presented in this study is helpful in collecting OCV delivery costs in a standardized manner, comparing delivery costs, planning vaccination campaigns and informing decision-making.

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Section: Introductionmentioning

confidence: 99%

Oral Cholera Vaccination Delivery Cost in Low- and Middle-Income Countries: An Analysis Based on Systematic Review

et al. 2016

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“…In Viet Nam, an estimated 10.9 million doses of ORC-Vax™ and mORC-VAX™ have been deployed from 1997 to 2013 through targeted mass vaccination or – to children – through the Expanded Programme of Immunization in cholera-endemic regions. 30 – 33 Documented coverage during the vaccination of half of the communes in Hue was 79% (118 703/149 557) in 1998 and 75% (103 226/137 082) in the other half in 2000; long term vaccine effectiveness (three to five years after the campaign) was 50%. 30 , 31 ( Table 2 ).Vaccine coverage was not precisely quantified in the 2008 Hanoi campaign; vaccine effectiveness was 76%.…”

Section: Resultsmentioning

confidence: 99%

“…To be able to compare the campaigns, we calculated the total delivery cost per fully immunized person by excluding the expenditures for vaccine, shipment and technical experts, but the estimates still varied considerably. Deployment costs were lowest in Hue, Viet Nam, where the vaccine is administered routinely through the public health system 30 , 33 but a similar delivery strategy may not be possible in other cholera-endemic areas or during the acute phase of emergencies. The requirement for co-administration of a buffer with the Dukoral® vaccine complicates the delivery of such vaccine and likely increases its delivery costs.…”

Section: Discussionmentioning

confidence: 99%

Post-licensure deployment of oral cholera vaccines: a systematic review

Martin

Lopez

Bellos

et al. 2014

Bull. World Health Organ.

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ObjectiveTo describe and analyse the characteristics of oral cholera vaccination campaigns; including location, target population, logistics, vaccine coverage and delivery costs.MethodsWe searched PubMed, the World Health Organization (WHO) website and the Cochrane database with no date or language restrictions. We contacted public health personnel, experts in the field and in ministries of health and did targeted web searches.FindingsA total of 33 documents were included in the analysis. One country, Viet Nam, incorporates oral cholera vaccination into its public health programme and has administered approximately 10.9 million vaccine doses between 1997 and 2012. In addition, over 3 million doses of the two WHO pre-qualified oral cholera vaccines have been administered in more than 16 campaigns around the world between 1997 and 2014. These campaigns have either been pre-emptive or reactive and have taken place under diverse conditions, such as in refugee camps or natural disasters. Estimated two-dose coverage ranged from 46 to 88% of the target population. Approximate delivery cost per fully immunized person ranged from 0.11–3.99 United States dollars.ConclusionExperience with oral cholera vaccination campaigns continues to increase. Public health officials may draw on this experience and conduct oral cholera vaccination campaigns more frequently.

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“…Only minor adverse events have been associated with OCV from over 10 m doses administered in the >13 year program in Vietnam, and 1.6 million doses administered in recent projects. High short-term effectiveness was found in Guinea [24], 5-year effectiveness was documented in Kolkata, India, [10] and long-term disease control and environmental decontamination observed in Vietnam [21].…”

Section: Findings From Seven Recent Campaigns Using Oral Cholera Vaccinementioning

confidence: 98%

Introducing cholera vaccination in Asia, Africa and Haiti: A meeting report

Hall

Sack

2015

Vaccine

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Orally-administered cholera vaccine (OCV) has been increasingly examined as an additional tool to intervene against endemic and epidemic cholera. In 2013, short- and long-term field experience with OCV under nine distinctive field settings was reported from India, Bangladesh, Vietnam, Guinea, Haiti, and Thailand. Lead investigators from each of these projects presented their findings at a symposium chaired by Drs. David A. Sack and Robert H. Hall at the Vaccines for Enteric Diseases (VED) Conference in Bangkok on November 7, 2013. The objective of the symposium was to describe the unique features of each setting and project, share field experience of implementing cholera vaccination, discuss results, and identify constraints to the wider use of OCV. The VED provided a forum where >200 attendees engaged with this exciting and potentially decisive new development in the cholera field.

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Oral Cholera Vaccine Development and Use in Vietnam

Abstract: Anna Lena Lopez and colleagues give an overview of the cholera situation in Vietnam and discuss how an oral cholera vaccine was developed and used as a component of a public health strategy against the disease. Please see later in the article for the Editors' Summary

Cited by 22 publications

References 19 publications

Oral Cholera Vaccination Delivery Cost in Low- and Middle-Income Countries: An Analysis Based on Systematic Review

Oral Cholera Vaccination Delivery Cost in Low- and Middle-Income Countries: An Analysis Based on Systematic Review

Post-licensure deployment of oral cholera vaccines: a systematic review

Introducing cholera vaccination in Asia, Africa and Haiti: A meeting report

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