Evidence of the risks and benefits of vaccinating pregnant women with WHO pre-qualified cholera vaccines during mass campaigns

Global Task Force on Cholera Control (GTFCC) World Health Organisation (WHO) (2016) C_WHO
The technical note from the Global Task Force on Cholera Control (GTFCC) examines the risks and benefits of vaccinating pregnant women with WHO-prequalified oral cholera vaccines (OCVs) during mass vaccination campaigns. It highlights that three WHO-approved vaccines (Dukoral®, Shanchol™, and Euvichol®) offer sustained protection and a strong safety profile. While these vaccines are not explicitly contraindicated for pregnant women, there is limited clinical data on their use during pregnancy. However, studies indicate that pregnant women with cholera face higher risks of fetal loss, stillbirth, and complications, especially if they experience severe dehydration. Some evidence suggests that vaccination can reduce cholera incidence in pregnant women and indirectly protect infants. Although no controlled trials have focused on pregnant women, retrospective studies in Guinea and Zanzibar showed no significant increase in adverse pregnancy outcomes after OCV administration. The GTFCC concludes that the benefits of vaccination outweigh the risks, particularly in high-risk areas, and recommends including pregnant women in cholera vaccination campaigns while continuing to monitor safety data.