Call for cholera vaccine stockpile

WASHINGTON, D.C., USA: Amidst a cholera outbreak in Haiti that has spread to the neighbouring Dominican Republic, a group of experts convened by the Pan American Health Organization/World Health Organization (PAHO/WHO) has urged the creation of an international stockpile of cholera vaccine.

They’ve also called for the use of current vaccines in a pilot project in Haiti that would be expanded as more vaccine becomes available.

The recommendations were based on considerations including the limited supplies of available vaccine, studies of the vaccines’ safety and efficacy, and WHO recommendations on cholera vaccination, as well as conditions on the ground in Haiti.

“In the short term, we should make use of the limited amount of vaccine we have,” said Dr. Roger Glass, director of the Fogarty International Center and associate director for international research at the U.S. National Institutes of Health. “In the long term, we need to make sure we have adequate supplies to respond to cholera in Haiti, in the Americas and around the world.”

PAHO/WHO convened the meeting in response to renewed interest in cholera vaccination following reports that more vaccine might be available than previously believed.

Information shared during the meeting indicated that 100,000 doses of cholera vaccine are currently ready for shipment, but an additional 200,000 doses could become available in the next three months and up to one million doses in the second half of 2011. Two doses of vaccine are needed to confer protection against cholera.

“While the increased availability of a vaccine is certainly good news, it should be recognized that over 10 million people live in Haiti and over 10 million live in the Dominican Republic,” said Dr. Jon Andrus, PAHO’s deputy director and a leading vaccine expert. “Under no circumstances could there be enough vaccine – over 40 million doses – to vaccinate all the inhabitants of the island of Hispaniola over the next year.”

Participants said the situation in Haiti clearly demonstrates the need for an international stockpile of cholera vaccine, which would stimulate vaccine production and guarantee vaccine supplies.

“We have asked PAHO/WHO to dialogue with suppliers to see how much more vaccine they can produce and to dialogue with organizations who would be willing to finance the purchase of vaccine,” said Dr. Ciro de Quadros, executive vice-president of the Sabin Vaccine Institute and head of the Technical Advisory Group of PAHO’s immunization program.

At the same time, the experts urged the development of a pilot project in Haiti that would utilize the immediately available vaccine and also provide lessons on how to introduce cholera vaccine effectively in a country that not only has an ongoing epidemic but also is recovering from a major earthquake. The group has asked PAHO/WHO to design such a project and to seek funding for it.

Since mid-October, Haiti’s cholera epidemic has sickened at least 112,000 people and claimed almost 2,500 lives. In the Dominican Republic, more than 100 cases and one fatality have been confirmed.


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