Cholera Vaccines

Cholera Vaccines April 2025

The U.S. Food and Drug Administration (FDA), the European Medicines Agency (EMA), the World Health Organization (WHO), and the U.K. National Health Service (NHS) recommend oral cholera vaccines (OCVs) for travelers visiting countries experiencing outbreaks. As of April 23, 2025, the World Health Organization (WHO) has prequalified Dukoral®, Shanchol™, Euvichol®, and Euvichol-S OCVs. In January 2025, the WHO stated OCV production had reached 6.2 million doses.

The WHO says that all OCVs require two vaccine doses for complete protection for up to three years, while a single dose provides short-term protection. GAVI says that in the current cholera outbreak, only one OCV dose course has been implemented in reactive vaccination campaigns. The U.K. The Health Security Agency published an updated cholera vaccination guidance (chapter 14) in August 2024.

As of April 2025, cholera vaccination is not generally recommended, as most international travelers do not typically visit areas affected by cholera outbreaks.

Dukoral® is administered with a buffer solution that requires 150 ml of clean water for adults. It can be administered to all individuals aged two and above.

Shanchol™ and Euvichol® are essentially the same vaccines produced by two different manufacturers. Euvichol-Plus® is a simplified formulation of the existing inactivated OCV jointly developed by Eubiologics and the International Vaccine Institute for cholera prevention. Euvichol®-S improves productivity by approximately 40% over Euvichol-Plus®. In January 2025, a batch of 948,500 doses of Euvichol-S arrived in Angola.

Vaxchora® (lyophilized CVD 103-HgR) is a single-dose, oral vaccine that the U.S. FDA approved in June 2016. The safety and effectiveness of VAXCHORA have not been established in individuals with immunocompromised conditions. In August 2023, the U.S. Centers for Disease Control and Prevention (CDC) published"Cholera Vaccine: Recommendations," highlighting CVD 103-HgR Vaxchora for travelers going to areas of active toxigenic Vibrio cholerae O1 transmission.

HILLCHOL® (BBV131) is a novel single-strain OCV developed by Bharat Biotech International Limited under Hilleman Laboratories license and funded by Merck and Wellcome Trust. It is a two-dose vaccine that BBIL states needs to be administered orally on Day 0 and Day 14. HILLCHOL® is suitable for individuals over one year old and is presented in a mono-multidose format.

Cholera Vaccine Supply

The International Coordinating Group (ICG) on Vaccine Provision has managed and coordinated the provision of OCV supplies and vaccines since 2013. Since the ICG's establishment in 1997, the WHO, UNICEF, and Médecins sans Frontières have facilitated the distribution of over 73 million doses of OCV to 23 countries. The OCV vaccine dashboard was updated for April 2025. In March 2025, the average stockpile of Oral Cholera Vaccine stabilized at 5.2 million doses, the fourth consecutive month above five million. The WHO noted that the increased OCV production has yet to meet growing global needs as demand exceeds supply.

Cholera Outbreaks

Cholera outbreaks continued in 22 countries in April 2025.

Cholera Vaccine News

April 22, 2025 - The WHO published a Multi-country cholera outbreak, External Situation Report #25.

December 18, 2024 - The WHO reported that a persistent shortage of OCVs continues to hinder efforts to control cholera outbreaks and respond promptly to the disease’s spread. 

October 17, 2024 - The WHO reported that OCVs are unavailable.

August 15, 2024 - The WHO reported that the global cholera response remains affected by a critical shortage of OCVs, as demand continues to outpace supply. Since January 2023, 18 countries have requested 105 million doses, nearly double the 55 million doses produced in this period.

April 15, 2024 - EuBiologics and IVI announced that Euvichol-S achieved WHO prequalification.

March 20, 2024 - The WHO stated: We appeal to vaccine manufacturers, governments, donors, and partners to prioritize an urgent scale-up of vaccine production and invest in all the efforts needed to prevent and control cholera. 

August 28, 2023 - The Republic of Kenya vaccinated about 1.6 million people with OCVs in August 2023.

December 5, 2022 - The U.S. CDC published Travelers Returning to the U.S. with Cholera – Information and CDC Guidance for Healthcare Providers.

October 19, 2022—The WHO Director-General announced that four agencies have decided to suspend the two-dose OCV vaccination strategy in favor of a one-dose approach, allowing more people to receive some protection from limited stocks.