Organization and implementation of an oral cholera vaccination by using leftover vaccine from a reactive campaign in an endemic urban setting in Chattogram, Bangladesh

Résumé fourni par la source

Objective Cholera poses a substantial public health challenge in most developing nations, including Bangladesh. In cholera-endemic settings, optimizing vaccine utilization is crucial to prevent wastage and strengthen outbreak preparedness. This study demonstrates an innovative approach to repurposing left-over doses from an oral cholera vaccine (OCV) campaign, ensuring efficient use while addressing ongoing transmission risks. We assessed the feasibility and impact of this strategy, highlighting its role in supporting the establishment of national vaccine stockpiles. This study describes the strategic repurposing of leftover OCV doses from a previous campaign in Dhaka to control an acute watery diarrhea (AWD) outbreak in Bandar Thana, Chattogram, and examines the feasibility of maintaining an in-country stockpile for emergency use. Study design This was a descriptive study analysis. Method A reactive campaign of Oral Cholera Vaccine (OCV) was initiated in five hotspot areas of Dhaka city in March 2022, and a total of 2.4 million individuals received vaccines Approximately 330,000 doses were retained after the campaign. In response to the prevailing necessity, the aforementioned surplus vaccines were reassigned to mitigate a recent outbreak of cholera in Bhasan Char, Noakhali and Bandar Thana, Chattogram. Result The reactive campaign was successfully conducted in two rounds, specifically targeting wards 38 and 39, to reach an estimated population of 135,000 high-risk inhabitants. To ensure the efficient delivery of the vaccine, the immunization campaign led by Communicable Disease Control (CDC), Bangladesh included the involvement of diverse stakeholders, robust advocacy and mobilization, several vaccination sites, and meticulously managed staff. A total of 135,233 and 128,206 doses of OCV were delivered in the first and second-round campaigns respectively. The administrative coverage of two doses of OCV was 91.5%. Lessons from this initiative highlight the importance of maintaining a national OCV stockpile to enhance outbreak preparedness and response capacity. Conclusion This study demonstrates that reallocating surplus OCV doses is a viable and effective strategy for outbreak control, reducing vaccine wastage while ensuring timely protection in high-risk areas. Our findings support the establishment of national vaccine stockpiles to enable swift, context-specific cholera interventions in endemic regions.

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