Cholera Vaccines

Cholera Vaccines 2025

The U.S. Food and Drug Administration (FDA), the European Medicine Agency (EMA), the World Health Organization (WHO), and the U.K. NHS recommend oral cholera vaccines (OCV) for travelers visiting countries that are undergoing outbreaks. As of March 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.

In 2025, cholera vaccination is not generally recommended because most international travelers do not visit cholera outbreaks.

Dukoral® is administered with a buffer solution that requires 150 ml of clean water for adults. It can be given to all individuals over the age of 2.

Shanchol™ and Euvichol® are essentially the same vaccines produced by two different manufacturers.

Euvichol-Plus® is an inactivated OCV jointly developed by Eubiologics and the International Vaccine Institute for cholera prevention. Euvichol®-S improves productivity by approximately 40% over Euvichol-Plus®.

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 immunocompromised persons. 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 says needs to be orally administered 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 over 73 million doses of OCV for 23 countries. The OCV vaccine dashboard was updated for February 2025. The WHO stated OCV production was high in December 2024 at 5.5 million doses, thanks to a simplified formulation and production process introduced and prequalified in 2024. 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 19 countries in March 2025.

Cholera Vaccine News

February 23, 2025 - The WHO published a Multi-country cholera outbreak, External Situation Report #23.

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 continues to be 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. 

February 12, 2024 - The WHO published situation report #11.

December 7, 2023 - The WHO published report #9 regarding active cholera outbreaks.

November 2, 2023 - The WHO published a Multi-country cholera outbreak, External Situation Report #8.

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

June 1, 2023 - The WHO published a Multi-country cholera outbreak, External Situation Report #3.

May 15, 2023 - The WHO published a Multi-country cholera outbreak, External Situation Report #2.

March 22, 2023 - The WHO published - Multi-country Cholera Outbreaks, External Situation Report #1.

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 stated that four agencies decided to suspend the two-dose OCV vaccination strategy in favor of a one-dose approach so that more people receive some protection from limited stocks.