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Meta-Analysis
. 2018 Jun 1;66(12):1960-1971.
doi: 10.1093/cid/cix1039.

Immunogenicity and Protection From a Single Dose of Internationally Available Killed Oral Cholera Vaccine: A Systematic Review and Metaanalysis

Anna Lena Lopez  1   2 , Jacqueline Deen  1   2 , Andrew S Azman  3 , Francisco J Luquero  4 , Suman Kanungo  5 , Shanta Dutta  5 , Lorenz von Seidlein  2   6 , David A Sack  2
Affiliations
Meta-Analysis

Immunogenicity and Protection From a Single Dose of Internationally Available Killed Oral Cholera Vaccine: A Systematic Review and Metaanalysis

Anna Lena Lopez et al. Clin Infect Dis. .

Abstract

In addition to improved water supply and sanitation, the 2-dose killed oral cholera vaccine (OCV) is an important tool for the prevention and control of cholera. We aimed to document the immunogenicity and protection (efficacy and effectiveness) conferred by a single OCV dose against cholera. The metaanalysis showed that an estimated 73% and 77% of individuals seroconverted to the Ogawa and Inaba serotypes, respectively, after an OCV first dose. The estimates of single-dose vaccine protection from available studies are 87% at 2 months decreasing to 33% at 2 years. Current immunologic and clinical data suggest that protection conferred by a single dose of killed OCV may be sufficient to reduce short-term risk in outbreaks or other high-risk settings, which may be especially useful when vaccine supply is limited. However, until more data suggest otherwise, a second dose should be given as soon as circumstances allow to ensure robust protection.

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Figures

Figure 1.
Figure 1.
Selection of reports included in the analysis.
Figure 2.
Figure 2.
Seroconversion after the first and second dose of a bivalent oral cholera vaccine, all age groups. Abbreviation: GMT, geometric mean titer.
Figure 3.
Figure 3.
Seroconversion to the Ogawa serotype after the first and second dose of a bivalent oral cholera vaccine in young children (A), children (B), and adults (C). Abbreviations: CI, confidence interval; GMT, geometric mean titer.
Figure 4.
Figure 4.
Estimated protection (95% confidence intervals) conferred by a single dose of killed oral cholera vaccine, by study site and duration.
See this image and copyright information in PMC

References

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