Preventive Cholera Vaccination Campaign Resumes Amid Global Supply Increase

The global supply of oral cholera vaccines (OCV) has significantly increased, allowing the resumption of preventive vaccination efforts for the first time in over three years, according to announcements made by Gavi, the Vaccine Alliance, UNICEF, and the World Health Organization (WHO). Mozambique leads the way in restarting its preventive vaccination program due to ongoing cholera outbreaks and recent flooding that has affected over 700,000 individuals, exacerbating the risk of waterborne diseases such as cholera.

The preventive vaccination campaign in Mozambique comes as the country grapples with the consequences of these floods, which disrupted both health and water systems, heightening vulnerability to cholera and other illnesses. This resumption is seen as a critical step toward breaking the reactive cycle of addressing cholera outbreaks without prior preventive measures. WHO Director-General Dr. Tedros Adhanom Ghebreyesus emphasized the importance of sufficient vaccine supplies, thanking the manufacturer EUBiologics for ramping up production to meet the substantial demand created by escalating cholera cases globally.

A total of 20 million doses is being allocated in this first phase of distribution. Mozambique will receive 3.6 million doses, 6.1 million doses will go to the Democratic Republic of the Congo, which is currently facing significant cholera outbreaks, and 10.3 million doses are set for Bangladesh. This marks a significant turnaround in vaccine availability, as global production of OCV has nearly doubled from 35 million doses in 2022 to approximately 70 million doses in 2025. These vaccines are financed by Gavi, with procurement and delivery executed by UNICEF.

Dr. Sania Nishtar, CEO of Gavi, remarked on the importance of sustainable vaccine supply, highlighting that the recent surge in cholera cases underscored its global public good status. She expressed gratitude to partners and donors, which have made it possible to finance essential vaccination programs. UNICEF Executive Director Catherine Russell noted that the resumption of vaccination will help protect vulnerable children and mitigate the spread of cholera, but she also stressed the necessity of improving access to safe water and sanitation in conjunction with vaccination efforts.

The allocation of vaccines to Mozambique, Bangladesh, and the DRC was based on established criteria set by the Global Task Force for Cholera Control (GTFCC), which includes over 50 organizations. This approach aims to ensure that vaccines are distributed systematically and equitably.

Dr. Ilesh Jani, chair of the GTFCC Steering Committee, indicated that the collaboration among various global stakeholders demonstrates the power of unified efforts in building a robust response to cholera. He noted that preventive vaccination can significantly shield at-risk communities and provide essential time to prepare for larger challenges ahead. Long-term investments in infrastructure are necessary for sustained improvements in cholera prevention.

The increase in OCV availability is a result of extensive efforts by global agencies, manufacturers, and partnerships aimed at meeting the high demand for vaccines to address ongoing outbreaks and to enhance production capabilities. The safety and efficacy of OCV have been confirmed, with one dose offering short-term protection for a minimum of six months; however, two doses provide longer-lasting protection against cholera for up to three years.

Although the supply of vaccines is recovering, the one-dose strategy remains the standard method for outbreak responses, with the consideration of two doses being made case by case.

Cholera, transmitted through contaminated water and food, can result in severe diarrhea and dehydration, potentially leading to death without prompt treatment. High-risk areas frequently lack adequate safe water and sanitation services and are often affected by conflict and poverty. According to WHO reports, over 600,000 cases of cholera and acute watery diarrhea, with nearly 7,600 deaths, were documented across 33 countries last year. However, these figures are likely underreported.

Since 2021, cholera cases have escalated year after year, but there was a decline observed in 2025. Conversely, the total number of cholera-related deaths has unfortunately continued to rise during this timeframe.

Vaccination is merely one component of a comprehensive strategy for cholera prevention and control. Long-term commitments to safe water, adequate sanitation, hygiene infrastructure, disease surveillance, rapid treatment, and community engagement are crucial elements required to avert outbreaks and reduce mortality over time.