Cholera Vaccine Safe While Pregnant

An observational study demonstrated that the killed oral vaccine Shanchol was not associated with increased adverse outcomes in pregnant women or their newborns.

"Our study provides evidence that fetal exposure to oral cholera vaccine confers no significantly increased risk of pregnancy loss, neonatal mortality, or malformation," the authors wrote.

"These data, along with findings from two retrospective studies, support use of oral cholera vaccine in pregnant women in cholera-affected regions," these researchers added, referring to studies involving Dukoral and Shanchol.

Shanchol costs about US $1.85 per dose.

A single-dose oral cholera vaccine intended for international travelers has been approved by the US Food and Drug Administration (FDA), making a cholera vaccine available to US travelers.

The cholera vaccine, Vaxchora, made by PaxVax, is the only FDA approved product, is intended for people ages 18 through 64 who plan to travel to cholera-ridden areas. It targets Vibrio cholerae serogroup O1, the globally dominant cause of cholera.

Two other oral cholera vaccines, Dukoral and ShanChol, are available elsewhere, but they require two doses and can take weeks to confer protection, according to the Centers for Disease Control and Prevention.

Cholera is a serious dehydrating diarrhoeal disease caused by toxigenic serogroups (O1 and O139) of Vibrio cholerae, which is spread by faecal contamination of water and food.

Cholera affects up to 2·8 million people and kills approximately 91,000 each year. Children aged younger than 5 years have the greatest incidence of disease in endemic areas.

Among pregnant women, cholera can cause serious complications, fetal loss, with rates varying from 2% to 36%.

The study was funded by the Bill & Melinda Gates Foundation. The study authors did not disclose any conflicts of interest: Pedro L Moro, Lakshmi Sukumaran.