Amid a surge of cholera cases in Haiti the Pan-American Health Organization (PAHO) reported in December 2022 that 1.17 million doses of oral vaccines had arrived. The vaccine was provided by the International Coordinating Group on Vaccine Provision (ICG), which oversees the global cholera vaccine stockpile, after a request from Haiti’s Ministry of Public Health. With a vaccination programme set to target people over the age of one in the next few days, hopes are high for stopping the spread.  

The situation on the ground 

PAHO Director, Dr Carissa Etienne, remarked that although Haiti has “experience in managing cholera”, the “fragile security situation” has hampered response efforts. The arrival of these doses is therefore “most welcome”. The WHO reports on this recent resurgence of cholera, declared on 2nd October 2022, which comes after “more than three years with no reported cases”. Furthermore, an “ongoing complex humanitarian crisis” is “rapidly deteriorating” to complicate containment efforts.  

As of early December, the National Department of Epidemiology, Laboratories, and Research (DELR) reported 1,220 confirmed cases and over 280 deaths in 8 departments, with over 14,100 suspected cases across all 10 departments. The WHO suggests that of the suspected cholera cases, 59% are male, and the most vulnerable age groups seem to be children aged 1-4, followed by adults between 20-39.  

Oral vaccination 

The WHO recommends the use of oral vaccination in combination with sanitation methods, as cholera is a water-borne disease. Euvichol is an inactivated vaccine manufactured in the Republic of Korea.  

The Director General of the Ministry of Health, Dr Lauré Adrien described the arrival of these doses as a “step in the right direction”.  

“We are integrating this tool into our national strategy, which includes surveillance, water and sanitation interventions, social mobilisation, and treatment.”  

He also hopes this “first shipment” will be “followed by others” so that all at-risk populations can benefit. PAHO suggests that an additional batch of a further 500,000 doses is expected in the coming weeks.  

In October we reported that cholera vaccination programmes were under pressure due to supply issues. As with the outbreak in Malawi, health officials are suggesting that vaccination might be a reactionary approach, where adequate safety and sanitation measures would be more sustainable.  

For more on vaccination strategies for emerging and re-emerging diseases join us at the World Vaccine Congress in Washington next year.