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{{Short description|Vaccine to prevent cholera}}
{{Drugbox
{{Use dmy dates|date=February 2023}}
| verifiedrevid = 408074728
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| type = vaccine
{{Infobox drug
| image =
| Verifiedfields = changed
| target = ]
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| vaccine_type = killed
| verifiedrevid = 446094983
| CAS_number =
| image = Dukoral_package_vaccine_vial.jpg
| ATC_prefix = J07

| ATC_suffix = AE01
<!-- Vacine data -->
| ATC_supplemental = {{ATC|J07|AE02}} {{ATC|J07|AE51}}
| type = vaccine
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| target = '']''
| vaccine_type = inactivated

<!-- Clinical data -->
| tradename = Dukoral, Vaxchora, others
| Drugs.com = {{drugs.com|CONS|cholera_vaccine}}
| DailyMedID = Cholera
| pregnancy_AU = B2
| pregnancy_category = <ref name="Vaxchora APMDS">{{cite web | title=Vaxchora APMDS | website=Therapeutic Goods Administration (TGA) | date=18 September 2023 | url=https://www.tga.gov.au/resources/auspmd/vaxchora | access-date=7 March 2024}}</ref>
| routes_of_administration = ]
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<!-- Legal status -->
| legal_AU = S4
| legal_AU_comment = <ref name="Vaxchora APMDS" /><ref>{{cite web |url=https://www.tga.gov.au/resources/artg/94483 |title=Summary for ARTG Entry:94483 Dukoral oral inactivated cholera vaccine liquid vial and buffer granules sachet |website=] (TGA) |access-date=30 July 2020}}</ref>
| legal_CA = Rx-only
| legal_CA_comment = /{{nbsp}}Schedule D<ref>{{cite web |title=Dukoral Product information |website=Health Canada |date=25 April 2012 |url=https://health-products.canada.ca/dpd-bdpp/info.do?lang=en&code=71450 |access-date=30 July 2020}}</ref>
| legal_UK = POM
| legal_UK_comment = <ref>{{cite web |title=Dukoral suspension and effervescent granules for oral suspension, Cholera vaccine (inactivated, oral) – Summary of Product Characteristics (SmPC) |website=(emc) |date=7 December 2015 |url=https://www.medicines.org.uk/emc/product/5087/smpc |access-date=30 July 2020}}</ref>
| legal_US = Rx-only
| legal_US_comment = <ref>{{cite web |title=Vaxchora – cholera vaccine, live, oral kit |website=DailyMed |date=24 October 2018 |url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=01dae2ac-8332-4e23-b971-67dc36c3ee16 |access-date=30 July 2020}}</ref><ref>{{cite web |title=Vaxchora – cholera vaccine, live, oral kit |website=DailyMed |url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7baa7ebb-cb08-4799-80d4-66c16966d223 |access-date=30 July 2020}}</ref>
| legal_EU = Rx-only
| legal_EU_comment = <ref>{{cite web |title=Eukoral EPAR |website=] (EMA) |date=17 September 2018 |url=https://www.ema.europa.eu/en/medicines/human/EPAR/dukoral |access-date=30 July 2020}}</ref><ref name="Vaxchora EPAR">{{cite web |title=Vaxchora EPAR |website=] (EMA) |date=30 January 2020 |url=https://www.ema.europa.eu/en/medicines/human/EPAR/vaxchora |access-date=30 July 2020}}</ref><ref>{{cite web | title=Vaxchora Product information | website=Union Register of medicinal products | url=https://ec.europa.eu/health/documents/community-register/html/h1423.htm | access-date=3 March 2023}}</ref>
| legal_status =

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| legal_status =
<!-- Chemical data -->
| routes_of_administration =
}} }}
'''Cholera vaccine''' is a ] used against ].<ref name="pmid18523643">{{cite journal |author=Mahalanabis D, Lopez AL, Sur D, ''et al.'' |title=A randomized, placebo-controlled trial of the bivalent killed, whole-cell, oral cholera vaccine in adults and children in a cholera endemic area in Kolkata, India |journal=PLoS ONE |volume=3 |issue=6 |pages=e2323 |year=2008 |pmid=18523643 |pmc=2396289 |doi=10.1371/journal.pone.0002323 |url=http://www.plosone.org/article/info:doi/10.1371/journal.pone.0002323}}</ref><ref>{{MeshName|Cholera+vaccines}}</ref>


<!-- Definition and medical uses -->
It is largely used by backpackers and persons visiting locations where there is a high risk of cholera infection. However, it does not provide 100% immunity from the disease, and food hygiene precautions should also be taken into consideration when visiting an area where there is a high risk of becoming infected with cholera.
A '''cholera vaccine''' is a ] that is effective at reducing the risk of contracting ].<ref name=WHO2017/> The recommended cholera vaccines are administered orally to elicit local immune responses in the gut where the intestinal cells produce antibodies against the cholera microbe. This immune response was poorly achieved with the injectable vaccines that were used until the 1970s. The first effective oral cholera vaccine was Dukoral, developed in Sweden in the 1980s. For the first six months after ] it provides about 85% protection, which decreases to approximately 60% during the first two years.<ref name=WHO2017/><ref name=Gra2010>{{cite journal |vauthors=Graves PM, Deeks JJ, Demicheli V, Jefferson T |title=Vaccines for preventing cholera: killed whole cell or other subunit vaccines (injected) |journal=The Cochrane Database of Systematic Reviews |issue=8 |pages=CD000974 |date=August 2010 |volume=2019 |pmid=20687062 |pmc=6532721 |doi=10.1002/14651858.CD000974.pub2}}</ref><ref name="pmid21412922">{{cite journal |vauthors=Sinclair D, Abba K, Zaman K, Qadri F, Graves PM |title=Oral vaccines for preventing cholera |journal=The Cochrane Database of Systematic Reviews |issue=3 |pages=CD008603 |date=March 2011 |volume=2011 |pmid=21412922 |pmc=6532691 |doi=10.1002/14651858.CD008603.pub2}}</ref> When enough of the population is immunized, it may protect those who have not been immunized thereby increasing the total protective impact to more than 90 % (known as ]).<ref name=WHO2017/>


<!-- Recommendations -->
A cholera vaccine is currently used in ].<ref name="pmid17055622">{{cite journal |author=Anh DD, Canh do G, Lopez AL, ''et al.'' |title=Safety and immunogenicity of a reformulated Vietnamese bivalent killed, whole-cell, oral cholera vaccine in adults |journal=Vaccine |volume=25 |issue=6 |pages=1149–55 |year=2007 |month=January |pmid=17055622 |doi=10.1016/j.vaccine.2006.09.049 |url=http://linkinghub.elsevier.com/retrieve/pii/S0264-410X(06)01049-8}}</ref>
The ] (WHO) recommends the use of three oral cholera vaccines – Dukoral, Shanchol, and Euvichol-Plus – in combination with other measures among those at high risk for cholera.<ref name=WHO2017/> Two vaccine doses with a 1–6 week interval are typically recommended.<ref name=WHO2017/> The duration of protection is at least two years in adults and six months in children aged 1–5 years.<ref name=WHO2017/> A live, attenuated single-dose oral vaccine is available for those traveling to an area where cholera is common but is not WHO approved for public health use.<ref name="Vaxchora FDA label">{{cite web |title=Vaxchora (Cholera vaccine, Live, Oral) |publisher=U.S. ] |url=https://www.fda.gov/media/98688/download |access-date=15 March 2017 |url-status=live |archive-url=https://web.archive.org/web/20170301015628/https://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM506235.pdf |archive-date=1 March 2017}}</ref><ref name="FDA Vaxchora approval letter">{{cite web |title=Vaxchora approval letter |publisher=U.S. ]|date=10 June 2016 |url=https://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM506321.pdf |access-date=30 July 2020 |archive-url=https://wayback.archive-it.org/7993/20170722071339/https://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM506321.pdf |archive-date=22 July 2017}} {{Source-attribution}}</ref><ref name="FDA Vaxchora"/>


<!-- Safety -->
Cholera vaccine for travellers is available in Italy, but not in France.
The available types of oral cholera vaccine are generally considered safe for the majority of the population.<ref name=WHO2017/> These vaccines were shown to be safe in ] and in those with ].<ref name="WHO2017" /> The main side effects that could be experienced include mild abdominal pain or diarrhea.<ref name=WHO2017/>


<!-- Society and culture -->
Although the protection observed has been described as "moderate", ] can multiply the effectiveness of vaccination.<ref name="pmid15993232">{{cite journal |author=Ali M, Emch M, von Seidlein L, ''et al.'' |title=Herd immunity conferred by killed oral cholera vaccines in Bangladesh: a reanalysis |journal=Lancet |volume=366 |issue=9479 |pages=44–9 |year=2005 |pmid=15993232 |doi=10.1016/S0140-6736(05)66550-6 |url=http://linkinghub.elsevier.com/retrieve/pii/S0140-6736(05)66550-6}}</ref> Although the vaccine can be dangerous for children, administration of the vaccine to adults can confer protection to children indirectly.<ref name="pmid18162935">{{cite journal |author=Ali M, Emch M, Yunus M, ''et al.'' |title=Vaccine Protection of Bangladeshi infants and young children against cholera: implications for vaccine deployment and person-to-person transmission |journal=Pediatr. Infect. Dis. J. |volume=27 |issue=1 |pages=33–7 |year=2008 |month=January |pmid=18162935 |doi=10.1097/INF.0b013e318149dffd |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?an=00006454-200801000-00007}}</ref>
The first cholera vaccines were developed in the late 19th century.<ref name=Vaccine2009/> They were the first widely used vaccines that were made in a laboratory but were largely abandoned in the 1970s due to their then-documented ] and poor efficacy.<ref name=Vaccine2009>{{cite book | vauthors = Stanberry LR |title=Vaccines for biodefense and emerging and neglected diseases |date=2009 |publisher=Academic |location=Amsterdam |isbn=978-0-08-091902-7 |page=870 |edition=1st |url=https://books.google.com/books?id=6Nu058ZNa1MC&pg=PA870 |url-status=live |archive-url=https://web.archive.org/web/20170908135337/https://books.google.com/books?id=6Nu058ZNa1MC&pg=PA870 |archive-date=8 September 2017}}</ref>


Oral cholera vaccines were first introduced in the 1990s.<ref name="WHO2017" /> It is on the ].<ref name="WHO21st">{{cite book |title=World Health Organization model list of essential medicines: 21st list 2019 |year=2019 |hdl=10665/325771 |publisher=World Health Organization |location=Geneva |id=WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO |hdl-access=free | vauthors = Organization WH }}</ref><ref name="WHO22nd">{{cite book |title=World Health Organization model list of essential medicines: 22nd list (2021) |year=2021 |hdl=10665/345533 |publisher=World Health Organization |location=Geneva |id=WHO/MHP/HPS/EML/2021.02 |hdl-access=free | vauthors = Organization WH }}</ref>
A drinkable cholera vaccine, '''dukoral''', also protects against ].


These vaccines are licensed for use in more than 60 countries.<ref name="WHO2017" /> In countries where the disease is common, the vaccine appears to be cost-effective.<ref name="WHO2017">{{cite journal |title=Cholera vaccines: WHO position paper – August 2017 |journal=Weekly Epidemiological Record |volume=92 |issue=34 |pages=477–498 |date=August 2017 |pmid=28845659 |hdl=10665/258764 | hdl-access=free }}</ref>
==References==
{{reflist|2}}


==Medical use==
{{Vaccines}}
In the late 20th century, oral cholera vaccines started to be used on a massive scale, with millions of vaccinations taking place, as a tool to control cholera outbreaks in addition to the traditional interventions of improving safe water supplies, sanitation, handwashing, and other means of improving hygiene.<ref>{{cite journal |vauthors=Harris JB, LaRocque RC, Qadri F, Ryan ET, Calderwood SB |title=Cholera |journal=Lancet |volume=379 |issue=9835 |pages=2466–76 |date=June 2012 |pmid=22748592 |pmc=3761070 |doi=10.1016/s0140-6736(12)60436-x}}</ref> The Dukoral vaccine, which combines ]- and heat-killed whole cells of '']'' O1 and a recombinant cholera toxin B subunit, was licensed in 1991 and has been used widely, mainly for travellers.<ref name=WHO2017/> The Shanchol bivalent vaccine, which combines the O1 and O139 ], was originally developed in Vietnam under the name mORCVAX in 1997 and given in 20 million doses in Vietnam's public health programme during the following decade through targeted mass vaccination of school-aged children in cholera endemic regions.<ref name=WHO2017/>


The ] (WHO) recommends both preventive and reactive use of the vaccine, making the following key statements:<ref>{{cite book |title=Oral cholera vaccines in mass immunization campaigns: guidance for planning and use |year=2010 |publisher=World Health Organization |isbn=978-92-4-150043-2 |url=http://apps.who.int/iris/bitstream/handle/10665/44448/9789241500432_eng.pdf |url-status=live |archive-url=https://web.archive.org/web/20140903045312/http://whqlibdoc.who.int/publications/2010/9789241500432_eng.pdf |archive-date=3 September 2014}}</ref>
]


{{blockquote|WHO recommends that currently available cholera vaccines be used as complements to traditional control and preventive measures in areas where the disease is endemic and should be considered in areas at risk for outbreaks. Vaccination should not disrupt the provision of other high-priority health interventions to control or prevent cholera outbreaks... Reactive vaccination might be considered in view of limiting the extent of large prolonged outbreaks, provided the local infrastructure allows it, and an in-depth analysis of past cholera data and identification of a defined target area have been performed.}}


The observed vaccine-specific protection with two doses of the oral vaccine was 58–76%.<ref>{{cite journal |vauthors=Bi Q, Ferreras E, Pezzoli L, Legros D, Ivers LC, Date K, Qadri F, Digilio L, Sack DA, Ali M, Lessler J, Luquero FJ, Azman AS |title=Protection against cholera from killed whole-cell oral cholera vaccines: a systematic review and meta-analysis |journal=Lancet Infect Dis |volume=17 |issue=10 |pages=1080–8 |date=October 2017 |pmid=28729167 |pmc=5639147 |doi=10.1016/S1473-3099(17)30359-6 }}</ref> ] can multiply the effectiveness of vaccination.<ref name="WHO2017" /> Dukoral has been licensed for children two years of age and older, Shanchol and Euvichol-Plus for children one year of age and older. The administration of the vaccine to adults confers additional indirect protection (herd immunity) also to children.
{{vaccine-stub}}


{{As of|2013}}, the WHO established a revolving stockpile, initially of only 2 million oral cholera vaccine doses.<ref>{{cite web |title=Oral cholera vaccine stockpile |url=https://www.who.int/cholera/vaccines/ocv_stockpile_2013/en/index.html |publisher=World Health Organization |access-date=18 December 2013 |archive-url=https://web.archive.org/web/20131212105249/http://www.who.int/cholera/vaccines/ocv_stockpile_2013/en/index.html |archive-date=12 December 2013}}</ref> With donations from mainly the ] the stockpile has progressively expanded to now more than 40 million doses per year.<ref>{{cite web |date=8 January 2016 |title=WHO Doubles Global Supply of Cholera Vaccine |url=https://www.nbcnews.com/health/health-news/world-health-organization-doubles-cholera-vaccine-supply-n492796 |url-status=live |archive-url=https://web.archive.org/web/20160108212639/https://www.nbcnews.com/health/health-news/world-health-organization-doubles-cholera-vaccine-supply-n492796 |archive-date=8 January 2016 |access-date=9 January 2016 |website=]}}</ref><ref>{{cite web |title=GAVI Board Approves Support to Expand Oral Cholera Vaccine Stockpile |url=http://www.taskforce.org/press-room/press-releases/gavi-board-approves-support-expand-oral-cholera-vaccine-stockpile |archive-url=https://web.archive.org/web/20131216184528/http://www.taskforce.org/press-room/press-releases/gavi-board-approves-support-expand-oral-cholera-vaccine-stockpile |archive-date=16 December 2013 |access-date=18 December 2013 |publisher=The Task Force on Global Health}}</ref> It consists mainly of the Euvichol-Plus oral cholera vaccine being produced in South Korea. In total more than 150 million doses from the stockpile have been given in mass campaigns against both epidemic and endemic cholera in more than 25 cholera-affected countries. A set goal of WHO's Global Task Force for Cholera Control (GTFCC) is, by using oral cholera vaccine and other available tools, by 2030 to have reduced cholera deaths by more than 90% and stopped transmission globally. &nbsp;
]

]
===Oral===
]
] buffer]]

The oral vaccines are generally of two forms: ] and ].<ref>{{Cite web |title=Cholera |url=https://www.who.int/teams/health-product-policy-and-standards/standards-and-specifications/vaccines-quality/cholera |access-date=2024-05-03 |website=] (WHO)}}</ref>

The first developed effective oral cholera vaccine, Dukoral, is a monovalent inactivated vaccine containing killed whole cells of '']'' O1 plus additional recombinant cholera toxin B subunit. Bacterial strains of both Inaba and Ogawa serotypes and of El Tor and Classical biotypes are included in the vaccine. Dukoral is taken orally with bicarbonate buffer, which protects the antigens from gastric acid. The vaccine acts by inducing antibodies against both the bacterial components and ]. The antibacterial intestinal antibodies prevent the bacteria from attaching to the intestinal wall, thereby impeding colonisation of V. cholerae O1. The anti-toxin intestinal antibodies prevent the cholera toxin from binding to the intestinal mucosal surface, thereby preventing the toxin-mediated diarrhoeal symptoms.<ref>{{cite web |title=Dukoral Canadian Product Monograph Part III: Consumer Information |url=http://www.dukoralcanada.com/sites/default/files/consumer_info_en.pdf |archive-url=https://web.archive.org/web/20160822025807/https://www.dukoralcanada.com/sites/default/files/consumer_info_en.pdf |archive-date=22 August 2016 |access-date=8 May 2013 |website=Dukoral}}</ref>

The two later inactivated oral cholera vaccines recommended by WHO, Shanchol, and Euvichol-Plus, have an identical composition, containing killed whole cells of ''V. cholerae'' O1 (the same components as in Dukoral) plus formalin-killed ''V. cholerae'' O139 bacteria.<ref name="WHO2017" />

A live, attenuated oral vaccine (CVD 103-HgR or Vaxchora), derived from a serogroup O1 classical Inaba strain, was approved for use in travellers by the US FDA in 2016.<ref name="Vaxchora FDA label"/><ref name="FDA Vaxchora PR"/><ref name="FDA Vaxchora approval letter"/>

In 2024, the Euvichol-S vaccine, an optimized version of Euvichol-Plus, received WHO prequalification. This streamlined formulation is designed to maintain effectiveness while reducing production costs, significantly boosting the global oral cholera vaccine supply to 50 million doses, up from 38 million. This increase addresses the growing demand amid rising cholera outbreaks since 2021.<ref>{{Cite press release |title=Gavi and UNICEF welcome approval of new oral cholera vaccine |url=https://www.unicef.org/press-releases/gavi-and-unicef-welcome-approval-new-oral-cholera-vaccine |access-date=2024-04-19 |website=UNICEF }}</ref>

===Injectable===
Although rarely in use, the injected cholera vaccines can be effective for people living where cholera is common. While being ineffective in young children, in such areas they can offer some degree of protection in adults and older children for up to six months.<ref name=Gra2010/>

==Side effects==
Both the inactivated and attenuated oral vaccines available are generally safe.<ref name=WHO2017/> Some of the common side effects include mild abdominal pain or diarrhea.<ref name=WHO2017/> They are safe in ] and in those with ].<ref name=WHO2017/>

==History of development==
] in ], Senegal, 1973]]
The first cholera vaccines were developed in the late 19th century. There were several pioneers in the development of the vaccine:
* The first known attempt at a cholera vaccine was made by ] and it was aimed at preventing cholera in chickens.<ref>{{cite journal | vauthors = Barranco C |date=28 September 2020 |title=The first live attenuated vaccines |url=https://www.nature.com/articles/d42859-020-00008-5 |journal=Nature Research }}</ref> This was the first widely used vaccine that was made in a laboratory.<ref name="Vaccine2009"/> Later use showed this early cholera vaccine to be ineffective.<ref>{{cite journal | vauthors = Dorsey TA, Harshfield GS |date = May 1959 |title=Studies on Control of Fowl Cholera |url=https://openprairie.sdstate.edu/agexperimentsta_tb/34 |journal=Agricultural Experiment Station Technical Bulletins (1939–2011)}}</ref>
* In 1884, Spanish physician ] developed a live vaccine he had isolated from cholera patients in Marseilles, and used it on over 30,000 individuals in Valencia during that year's epidemic. However, his vaccine and inoculation was rather controversial and was rejected by his peers and several investigation commissions,<ref name=":0">{{cite journal | vauthors = Bornside GH | title = Waldemar Haffkine's cholera vaccines and the Ferran-Haffkine priority dispute | journal = Journal of the History of Medicine and Allied Sciences | volume = 37 | issue = 4 | pages = 399–422 | date = December 1982 | pmid = 6759570 | doi = 10.1093/jhmas/XXXVII.4.399 }}</ref> but it ended up demonstrating its effectiveness and being recognized for it.<ref>{{cite journal |vauthors=Lopez AL, Gonzales ML, Aldaba JG, Nair GB |date = September 2014 |title= Killed oral cholera vaccines: history, development and implementation challenges |journal=Therapeutic Advances in Vaccines and Immunotherapy |volume=2 |issue=5 |pages=123–148 |pmc=4144262 |doi=10.1177/2051013614537819|pmid = 25177492 }}</ref>
* In 1892, ] developed an effective vaccine with less severe ]s, later testing it on more than 40,000 people in the Calcutta area from 1893 to 1896.<ref>{{cite book |title=Un illustre inconnu. Une biographie du docteur Waldemar Mordekhaï Haffkine. | trans-title = An illustrious stranger. A biography of Doctor Waldemar Mordechaï Haffkine | language = French | vauthors = Hanhart J |publisher=Lichma |year=2017 |isbn=978-2-912553-84-3 |location=Paris}}</ref> His vaccine was accepted by the medical community, and is credited as the first effective human cholera vaccine.<ref name=":0"/><ref name=":1">{{cite journal | vauthors = Bornside GH | title = Jaime Ferran and preventive inoculation against cholera | journal = Bulletin of the History of Medicine | volume = 55 | issue = 4 | pages = 516–532 | date = 1981 | pmid = 7039738 | jstor = 44441415 }}</ref><ref name=":2">{{cite journal | vauthors = Hawgood BJ | title = Waldemar Mordecai Haffkine, CIE (1860–1930): prophylactic vaccination against cholera and bubonic plague in British India | journal = Journal of Medical Biography | volume = 15 | issue = 1 | pages = 9–19 | date = February 2007 | pmid = 17356724 | doi = 10.1258/j.jmb.2007.05-59 | s2cid = 42075270 }}</ref><ref>{{cite news |date=11 December 2020 |title=Waldemar Haffkine: The vaccine pioneer the world forgot |work=BBC News |url=https://www.bbc.com/news/world-asia-india-55050012 |access-date=20 January 2021}}</ref>
* Finally, in 1896, ] introduced a heat-killed vaccine that was significantly easier to prepare than Haffkine's, using it on a large scale in Japan in 1902.<ref>{{cite book | vauthors = Artenstein AW |title=Vaccines: A Biography |date=2009 |publisher=Springer Science & Business Media |location=New York City |isbn=978-0-08-091902-7 |pages=89–92 |edition=1 |url=https://books.google.com/books?id=ewdL8ilILZAC |url-status=live |archive-url=https://web.archive.org/web/20170908135337/https://books.google.com/books?id=ewdL8ilILZAC |archive-date=8 September 2017}}</ref>

Oral cholera vaccines were first introduced in the 1990s.<ref name="WHO2017"/>

==Society and culture==

===Legal status===
In 2016, the US ] (FDA) approved Vaxchora,<ref name="FDA Vaxchora">{{cite web |title=Vaxchora |website=U.S. ] (FDA) |date=1 September 2019 |url=https://www.fda.gov/vaccines-blood-biologics/vaccines/vaxchora |access-date=28 December 2019}}</ref><ref name="FDA Vaxchora approval letter"/><ref name="FDA Vaxchora PR"/> a single-dose oral vaccine to prevent cholera for travelers. {{As of|2016|06}}, Vaxchora is the only FDA-approved vaccine for the prevention of cholera.<ref name="FDA Vaxchora PR">{{cite press release |title=FDA approves vaccine to prevent cholera for travelers |date=10 June 2016 |url=https://www.fda.gov/news-events/press-announcements/fda-approves-vaccine-prevent-cholera-travelers |publisher=U.S. ] (FDA) |url-status=live |archive-url=https://web.archive.org/web/20161218163210/https://www.fda.gov/news-events/press-announcements/fda-approves-vaccine-prevent-cholera-travelers |archive-date=18 December 2016}} {{PD-notice}}</ref>

===Economics===
The cost to immunize against cholera is between {{US$|0.10}} and $4.00 per vaccination.<ref name="ReferenceA">{{cite journal |vauthors=Martin S, Lopez AL, Bellos A, Deen J, Ali M, Alberti K, Anh DD, Costa A, Grais RF, Legros D, Luquero FJ, Ghai MB, Perea W, Sack DA |title=Post-licensure deployment of oral cholera vaccines: a systematic review |journal=Bulletin of the World Health Organization |volume=92 |issue=12 |pages=881–93 |date=December 2014 |pmid=25552772 |pmc=4264394 |doi=10.2471/blt.14.139949|doi-broken-date=15 November 2024 }}</ref>

The Vaxchora vaccine can cost more than $250.<ref>{{cite web |title=New Cholera Vaccine for Adult Travelers |url=http://www.medscape.com/viewarticle/878238 |publisher=Medscape |date=17 April 2017 |access-date=20 August 2017 |url-status=live |archive-url=https://web.archive.org/web/20170908135337/http://www.medscape.com/viewarticle/878238 |archive-date=8 September 2017}}</ref>

==References==
{{Reflist}}

==Further reading==
{{refbegin}}
* {{cite book |title=The immunological basis for immunization series: module 14: cholera |publisher=] (WHO) |year=2010 |hdl=10665/44367 |isbn=978-92-4-159974-0 |hdl-access=free}}
* {{cite book |title=Immunisation against infectious disease |chapter=Chapter 14: Cholera |chapter-url=https://www.gov.uk/government/publications/cholera-the-green-book-chapter-14 |year=2013 |publisher=Public Health England |veditors=Ramsay M |url=https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book}}
* {{cite book |chapter=Cholera |chapter-url=https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-related-infectious-diseases/cholera |title=CDC Yellow Book 2020: Health Information for International Travel |url=https://wwwnc.cdc.gov/travel/page/yellowbook-home-2014 |publisher=Oxford University Press |location=New York |year=2017}}
* {{cite report |title=Cholera and enterotoxigenic escherichia coli (ETEC) travellers' diarrhea vaccine: Canadian Immunization Guide |website=Health Canada |url=https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-3-cholera-enterotoxigenic-escherichia-coli-travellers-diarrhea-vaccine.html}}
{{refend}}

==External links==
* {{cite web |title=Cholera Vaccine Information Statement |date=15 October 2024 |publisher=U.S. ] (CDC) |url=https://www.cdc.gov/vaccines/hcp/vis/vis-statements/cholera.html }}
* {{MeSH name|Cholera Vaccines}}

{{Vaccines}}
{{Cholera}}
{{Portal bar |Medicine}}

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