Consensus Meeting on International Standards for Oral Whole Cell Killed Cholera Vaccines, 17-18 May 2018, Seoul, Republic of Korea

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Authors

  • Lina Odevall
  • Sjoerd Rijpkema
  • Dean Smith
  • Tong Wu
  • Firdausi Qadri
  • Jan Holmgren
  • Julia Lynch
  • Viliam Pavliak

DOI:

https://doi.org/10.17140/VROJ-4-112

Keywords:

Cholera, Oral cholera vaccine, LPS inhibition ELISA assay, WHO International standards

Abstract

Cholera causes an estimated 3 million cases of watery diarrhea and 100,000 deaths globally per year. Although the long-term
solution for cholera control lies in universal access to safe drinking water and adequate sanitation, Oral Cholera Vaccines (OCVs)
are the most cost-effective measure to contain and prevent the disease and are recommended by the World Health Organization
(WHO) as part of an integrated strategy to control cholera. Currently, three OCVs are WHO prequalified and two of these are part
of the cholera vaccine stockpile. Other OCVs have been developed for national use or are under development. Lipopolysaccharide
(LPS) Inhibition enzyme-linked immunosorbent assays (ELISAs) are used by both manufacturers of OCVs and national regulatory
agencies (NRAs) for: in process analysis, as a potency assay for drug substance and drug product batch release, and as an indicator of
stability during the shelf life of OCVs. To ensure quality and consistency of this assay performed by different OCV manufacturers
and NRAs, harmonization of assay reagents by the introduction of WHO International Standards (IS) for essential reagents is
desirable. In May 2018, the International Vaccine Institute (IVI) with assistance from National Institute of Biological Standards
and Control (NIBSC) and financial support from the Bill and Melinda Gates Foundation (BMGF) organized a meeting with
representatives from vaccine manufacturers, NRAs, leading research institutions and independent experts to discuss and share
experiences on potency assays for batch release and select reagents of the LPS Inhibition ELISA as candidate WHO ISs.

References

World Health Organization (WHO). Cholera vaccines: WHO position paper - August 2017. Wkly Epidemiol Rec. 2017; 92(34): 477-498. 17 Pavliak V, et al

Global Task Force on Cholera Control. Ending cholera: A global roadmap to 2030. 2017: 32.

World Health Organization (WHO). Global Health Observatory (GHO) data. Website: http://www.who.int/gho/epidemic_diseas-es/cholera/cases_text/en. Accessed March 25, 2019.

Baik YO, Choi SK, Olveda RM, et al. A randomized, non-infe-riority trial comparing two bivalent killed, whole cell, oral cholera vaccines (Euvichol vs Shanchol) in the Philippines. Vaccine. 2015; 33(46): 6360-6365. doi: 10.1016/j.vaccine.2015.08.075

Valera R, García HM, Jidy MD, et al. Randomized, double-blind, placebo-controlled trial to evaluate the safety and immunogenic-ity of live oral cholera vaccine 638 in Cuban adults. Vaccine. 2009; 27(47): 6564-6569. doi: 10.1016/j.vaccine.2009.08.042

Wierzba TF. Oral cholera vaccines and their impact on the global burden of disease. Hum Vaccin Immunother. 2018; 1-8. doi: 10.1080/21645515.2018.1504155

Abubakar A, Azman AS, Rumunu J, et al. The first use of the global oral cholera vaccine emergency stockpile: Lessons from South Sudan. PLoS Med. 2015; 12(11): e1001901. doi: 10.1371/ journal.pmed.1001901

Ferreras E, Chizema-Kawesha E, Blake A, et al. Single-dose cholera vaccine in response to an outbreak in Zambia. N Engl J Med. 2018; 378: 577-579. doi: 10.1056/NEJMc1711583

Ivers LC, Hilaire IJ, Teng JE, et al. Effectiveness of reactive oral cholera vaccination in rural Haiti: A case-control study and bias-indicator analysis. Lancet Glob Health. 2015; 3(3): e162-e168. doi:

1016/S2214-109X(14)70368-7 10. Ciglenecki I, Azman AS, Jamet C, Serafini M, Luquero FJ, Ca-brol J-C. Progress and challenges in using oral cholera vaccines to control outbreaks: The Médecins Sans Frontières experience. J In-fect Dis. 2018; 218(suppl_3): S165-S166. doi: 10.1093/infdis/jiy487

Zaidi A. Make plans to eliminate cholera outbreaks. Nature. 2017; 550(7674): 9. doi: 10.1038/550009a

World Health Organization (WHO). Oral Cholera Vaccines. Website: http://www.who.int/cholera/vaccines/en/. Accessed March 25, 2019.

World Health Organization (WHO). Dashboard: International Coordinating Group (ICG) on Vaccine Provision on cholera. Web-site: http://www.who.int/csr/disease/icg/cholera-dashboard/ en/. Accessed March 25, 2019.

Desai SN, Pezzoli L, Alberti KP, et al. Achievements and chal-lenges for the use of killed oral cholera vaccines in the global stockpile era. Hum Vaccin Immunother. 2017; 13(3): 579-587. doi: 10.1080/21645515.2016.1245250 Perspective Study | Volume 4 | Number 1|

Siddiqui FJ, Bhutto NS, von Seidlein L, Khurram I, Rasool S, Ali M, et al. Consecutive outbreaks of Vibrio cholerae O139 and V. cholerae O1 cholera in a fishing village near Karachi, Pakistan. Trans R Soc Trop Med Hyg. 2006; 100: 476-482. doi: 10.1016/j.trst-mh.2005.07.019

Waldor MK, Mekalanos JJ. Emergence of a new cholera pan-demic: Molecular analysis of virulence determinants in Vibrio chol-erae O139 and development of a live vaccine prototype. J Infect Dis. 1994; 170: 278-283.

Johnson RA, Uddin T, Aktar A, et al. Comparison of im-mune responses to the O-specific polysaccharide and lipopoly-saccharide of Vibrio cholerae O1 in Bangladeshi adult patients with cholera. Clin Vaccine Immunol. 2012; 19(11): 1712-1721. doi: 10.1128%2FCVI.00321-12

Ma X, Saksena R, Chernyak A, Kovác P. Neoglycoconjugates from synthetic tetra- and hexasaccharides that mimic the termi-nus of the O-PS of Vibrio cholerae O:1, serotype Inaba. Org Biomol Chem. 2003; 1(5): 775-784

Chatterjee SN, Chaudhuri K. Lipopolysaccharides of Vibrio cholerae. I. Physical and chemical characterization. Biochim Biophys Acta. 2003; 1639(2): 65-79.

Karlsson SL, Ax E, Nygren E, et al. Development of stable Vibrio cholerae O1 Hikojima type vaccine strains co-expressing the Inaba and Ogawa lipopolysaccharide antigens. PLoS One. 2014; 9(11): e108521. doi: 10.1371/journal.pone.0108521 Submit your article to this journal | https://openventio.org/submit-manuscript/ Perspective Study | Volume 4 | Number 1| Pavliak V, et al

Mosley WH, McCormack WM, Ahmed A, Chowdhury AK, Barui RK. Report of the 1966-67 cholera vaccine field trial in rural East Pakistan. 2. Results of the serological surveys in the study population--the relationship of case rate to antibody titre and an estimate of the inapparent infection rate with Vibrio cholerae. Bull World Health Organ. 1969; 40(2): 187-197.

Clemens JD, Nair GB, Ahmed T, Qadri F, Holmgren J. Chol-era. Lancet. 2017; 390(10101): 1539-1549. doi: 10.1016/S0140- 6736(17)30559-7

Svennerholm AM, Jertborn M, Gothefors L, Karim AM, Sack DA, Holmgren J. Mucosal antitoxic and antibacterial immunity after cholera disease and after immunization with a combined B subunit-whole cell vaccine. J Infect Dis. 1984; 149(6): 884-993. doi: 10.1093/infdis/149.6.884

World Health Organization (WHO). Controlled temperature chain (CTC). Website: http://www.who.int/immunization/pro-grammes_systems/supply_chain/ctc/en/. Accessed March 26, 2019.

World Health Organization (WHO). Sixty-sixth Meeting of the WHO Expert Committee on Biological Standardization, 12 to 16 October 2015. WHO Tech Rep Series 2016; 999: 235-264 (Annex 5) doi: WHO/BS/2015.2268.

World Health Organization (WHO). Sixty-eight meeting of the WHO Expert Committee on Biological Standardization. 2017. WHO Tech Rep Series 2018; 1011: 74-76.

Published

2019-04-09

How to Cite

Lina Odevall, Sjoerd Rijpkema, Dean Smith, Tong Wu, Firdausi Qadri, Jan Holmgren, … Viliam Pavliak. (2019). Consensus Meeting on International Standards for Oral Whole Cell Killed Cholera Vaccines, 17-18 May 2018, Seoul, Republic of Korea. Vaccination Research, 4(1), 12–18. https://doi.org/10.17140/VROJ-4-112