title: Considerations around the introduction of a cholera vaccine in Bangladesh.
abstract: Cholera is an endemic and epidemic disease in Bangladesh. On 3 March 2013, a meeting on cholera and cholera vaccination in Bangladesh was convened by the Foundation Mérieux jointly with the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B). The purpose of the meeting was to discuss the investment case for cholera vaccination as a complimentary control and prevention strategy. The performance of a new low cost oral cholera vaccine, Shanchol™, used in recent trials in Bangladesh, was also reviewed in the context of a potential large-scale public-sector vaccination program. Findings showed the oral vaccine to be highly cost-effective when targeting ages 1-14 y, and cost-effective when targeting ages 1+y, in high-burden/high-risk districts. Other vaccination strategies targeting urban slums and rural areas without improved water were found to be cost-effective. Regardless of cost-effectiveness (value), the budget impact (affordability) will be an important determinant of which target population and vaccination strategy is selected. Most importantly, adequate vaccine supply for the proposed vaccination programs must be addressed in the context of global efforts to establish a cholera vaccine stockpile and supply other control and prevention efforts.
authors.affiliation: Sabin Vaccine Institute, Washington, DC, USA. Electronic address: nelsoncb2004@gmail.org.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Nelson
authors.affiliation: International Vaccine Institute (IVI), Seoul, Republic of Korea.
authors.forename: Vittal
authors.initials: V
authors.lastname: Mogasale
authors.affiliation: EPI Programme Manager, Dhaka, Bangladesh.
authors.forename: Tajul Islam A
authors.initials: TI
authors.lastname: Bari
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Dhaka, Bangladesh.
authors.forename: John D
authors.initials: JD
authors.lastname: Clemens
mesh_terms: D000293:Adolescent; D001459:Bangladesh / Q000453:epidemiology; D002202:Capital Financing; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology* / Q000517:prevention & control*; D022121:Cholera Vaccines / Q000191:economics* / Q000276:immunology* / Q000600:supply & distribution; D003362:Cost-Benefit Analysis; D006291:Health Policy; D006801:Humans; D017589:Immunization Programs / Q000191:economics* / Q000458:organization & administration*; D007223:Infant
chemical_list: D022121:Cholera Vaccines
keywords: Bangladesh; Cholera; Vaccine