Efficacy of a Low-Cost, Inactivated Whole-Cell Oral Cholera Vaccine: Results from 3 Years of Follow-Up of a Randomized, Controlled Trial

摘要

New-generation vaccines against cholera are given orally, to stimulate intestinal immunity. An internationally available oral cholera vaccine (OCV) consists of killed vibrio whole cells together with the B subunit of cholera toxin, is safe, and protects vaccinated individuals against cholera for two years, but this vaccine has seen limited use due to its high cost. We developed a simpler, inactivated whole-cell only OCV that can be produced inexpensively and might therefore be attractive for use in developing countries, as well as for travelers from industrialized countries. We tested this new OCV in a randomized, controlled field trial that enrolled 69,328 individuals aged one year and older living in urban slums of Kolkata, India. At three years of follow-up after receiving at two-dose regimen of this OCV, the vaccinated population experienced 66% protection against all episodes of cholera occurring during the three years, and 65% protection against episodes occurring during the third year. Significant protection was evident in the second year in children vaccinated at ages 1–4 years and in the third year in persons vaccinated at ages of five years and older. Follow-up of the study population will continue for five years to ascertain the duration of vaccine protection.