MSF responds to change in global cholera vaccine strategy amid unprecedented number of outbreaks

MSF is responding to a cholera emergency in Port-au-Prince, Haiti

Haiti 2022 © Alexandre Marcou/MSF

NEW YORK/GENEVA, OCTOBER 19, 2022—Due to the high number of countries currently experiencing cholera outbreaks and a shortage of oral cholera vaccine, the International Coordinating Group (ICG) announced today that it will temporarily suspend the standard two-dose vaccination regimen administered during cholera outbreaks. Instead, a single dose of vaccine, which has proven effective in the past, will be given in order to protect more people.

The ICG is the international body that manages emergency supplies of vaccines and is made up of members from Doctors Without Borders/Médecins Sans Frontières (MSF), the World Health Organization, UNICEF, and the International Federation of Red Cross and Red Crescent Societies.

There are currently 29 countries experiencing cholera outbreaks—an unusually high number of countries—including Haiti and Syria. This unprecedented rise in cases is due to climate factors like floods and droughts, conflict, and forced displacement as there is often limited access to clean water in refugee and displacement camps, among other factors.

Dr. Daniela Garone, MSF’s international medical coordinator, said of today’s announcement:

"A critical global shortage of cholera vaccines has left MSF in the position of supporting the very difficult decision of reducing the doses people will receive from two to one. The vaccine, which was developed more than 10 years ago, is a desperately needed, lifesaving, preventive tool. It is incredibly frustrating to face this situation as cholera surges in more than 20 countries, including in places already devastated by crises like Haiti, Nigeria, and Syria.

"This last resort decision is a way to avoid making the impossible choice of sending doses to one country over another. Single dose vaccination will provide shorter protection, but it is the fair and equitable way to try to protect as many people as possible as we face simultaneous cholera outbreaks.

"This solution is only temporary, and the ongoing supply shortage is a serious concern for any short- and medium-term responses needed for additional cholera outbreaks this year. MSF teams have been engaged in past and ongoing cholera responses in many countries including Cameroon, Haiti, Malawi, Nigeria, Yemen, and Mozambique, and we have supported vaccination efforts as part of our responses."