Short-term effectiveness and impact of Vaxchora vaccine during the 2024 cholera outbreak in Mayotte
Abstract
Global cholera resurgence and vaccine shortage have driven the adoption of reactive one-dose strategies with killed oral cholera vaccines (OCVs). The live-attenuated vaccine CVD 103-HgR (Vaxchora) shows high efficacy in human challenge studies, but its real-world effectiveness in outbreaks is unknown. Here, we analyze the 2024 outbreak in Mayotte, focusing on Koungou village, which had high cholera incidence and vaccine uptake. We develop several stochastic models and calibrate them to daily cases by vaccination status. In total, 3354 individuals (71%) of Koungou’s at-risk population ( n = 4733) received CVD 103-HgR, and 77 cases were confirmed, with symptom onset between 19 April and 7 July 2024. At baseline, we estimate a basic reproduction number R0 R 0 of 1.5 (95% credible interval (CrI): 1.2, 1.9) and a CVD 103-HgR effectiveness in preventing cholera of 87% (95% CrI: 74, 99), remaining between 75% and 91% across scenarios. Counterfactual simulations estimate 536 (95% CrI: 240, 824) cases averted at baseline, with a range of point estimates from 152 to 1228 across sensitivity analyses. Rapid single-dose CVD 103-HgR deployment is associated with high effectiveness during a real‑world outbreak, with a substantial but more uncertain population impact, supporting the inclusion of live-attenuated OCVs in reactive strategies when necessary.
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BibTeX
@article{brault2026shortterm,
title = {{Short-term effectiveness and impact of Vaxchora vaccine during the 2024 cholera outbreak in Mayotte}},
author = {Antoine Brault and François Herry and Sara Mazzilli and Lina Cristancho-Fajardo and Margaux Froidefond and Mathieu Epinoux and Melissa Berot and Marion Soler and Annabelle Lapostolle and Francesco Camaglia and Kelly Charniga and Tanguy Cholin and Maxime Jean and Thierry Fouere and Assiati Ahmed and Mohamadou Niang and Juliette Paireau and Justin Lessler and Andrew S. Azman and Paolo Bosetti and Julien Balicchi and Simon Cauchemez},
journal = {Nature Communications},
year = {2026},
month = oct,
doi = {10.1038/s41467-026-78733-0},
url = {https://www.nature.com/articles/s41467-026-78733-0},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Short-term effectiveness and impact of Vaxchora vaccine during the 2024 cholera outbreak in Mayotte
AU - Antoine Brault
AU - François Herry
AU - Sara Mazzilli
AU - Lina Cristancho-Fajardo
AU - Margaux Froidefond
AU - Mathieu Epinoux
AU - Melissa Berot
AU - Marion Soler
AU - Annabelle Lapostolle
AU - Francesco Camaglia
AU - Kelly Charniga
AU - Tanguy Cholin
AU - Maxime Jean
AU - Thierry Fouere
AU - Assiati Ahmed
AU - Mohamadou Niang
AU - Juliette Paireau
AU - Justin Lessler
AU - Andrew S. Azman
AU - Paolo Bosetti
AU - Julien Balicchi
AU - Simon Cauchemez
PY - 2026
DA - 2026/10/19
JO - Nature Communications
DO - 10.1038/s41467-026-78733-0
UR - https://www.nature.com/articles/s41467-026-78733-0
AB - Global cholera resurgence and vaccine shortage have driven the adoption of reactive one-dose strategies with killed oral cholera vaccines (OCVs). The live-attenuated vaccine CVD 103-HgR (Vaxchora) shows high efficacy in human challenge studies, but its real-world effectiveness in outbreaks is unknown. Here, we analyze the 2024 outbreak in Mayotte, focusing on Koungou village, which had high cholera incidence and vaccine uptake. We develop several stochastic models and calibrate them to daily cases by vaccination status. In total, 3354 individuals (71%) of Koungou’s at-risk population ( n = 4733) received CVD 103-HgR, and 77 cases were confirmed, with symptom onset between 19 April and 7 July 2024. At baseline, we estimate a basic reproduction number R_0 R 0 of 1.5 (95% credible interval (CrI): 1.2, 1.9) and a CVD 103-HgR effectiveness in preventing cholera of 87% (95% CrI: 74, 99), remaining between 75% and 91% across scenarios. Counterfactual simulations estimate 536 (95% CrI: 240, 824) cases averted at baseline, with a range of point estimates from 152 to 1228 across sensitivity analyses. Rapid single-dose CVD 103-HgR deployment is associated with high effectiveness during a real‑world outbreak, with a substantial but more uncertain population impact, supporting the inclusion of live-attenuated OCVs in reactive strategies when necessary.
SN - 2041-1723
ER -