Uptake likelihood assessment of oral cholera vaccine capsules: insights from stakeholder consultations in five countries

Abstract

BackgroundThe global resurgence of cholera, a diarrhoeal disease, has resulted in vaccine demand that exceeds the currently available supply resulting in global calls for next generation cholera vaccines. DuoChol is a novel, thermostable, low-cost oral cholera vaccine capsule currently in development which has the potential to introduce programmatic benefits and efficiencies in cholera vaccination campaigns.ObjectivesThis qualitative study aimed to identify country-specific challenges in handling, distributing, and storing cholera vaccines and to assess the feasibility, acceptability, and policy implications of vaccine capsules compared to current products and practices in vaccination campaigns.MethodsUsing the World Health Organization's Vaccine Innovation Framework, consultations were conducted with 81 immunization programme stakeholders from Bangladesh, Ethiopia, Kenya, Mozambique and Tanzania.ResultsKey barriers to cholera vaccination include challenges in disbursing funds to subnational levels and the need for surged resources, such as additional health workers and cold chain equipment, during campaigns. Stakeholders discussed attributes of the novel vaccine such as improved thermostability and presentation which could reduce or eliminate the existing barriers.ConclusionsThe stakeholders highlighted that vaccine capsules are desirable for use in the general population as they have the potential to have many advantages over the current practice. However, for children who are not able to swallow the capsule, the currently available liquid oral cholera vaccine may be more desirable. To make an eventual informed decision about whether to recommend use of the vaccine capsule, national stakeholders requested the generation of evidence derived from pilot studies.