Geneva/New York, 19 October 2022 - A strained global supply of cholera vaccines has obliged the International Coordinating Group (ICG)—the body which manages emergency supplies of vaccines—to temporarily suspend the standard two-dose vaccination regimen in cholera outbreak response campaigns, using instead a single-dose approach. The pivot in strategy will allow for the doses to be used in more countries, at a time of unprecedented rise in cholera outbreaks worldwide. Since January this year, 29 countries have reported cholera cases, including Haiti, Malawi and Syria which are facing large outbreaks. In comparison, in the previous 5 years, fewer than 20 countries on average reported outbreaks. The global trend is moving towards more numerous, more widespread and more severe outbreaks, due to floods, droughts, conflict, population movements and other factors that limit access to clean water and raise the risk of cholera outbreaks. The one-dose strategy has proven to be effective to respond to outbreaks, even though evidence on the exact duration of protection is limited, and protection appears to be much lower in children. With a two-dose regimen, when the second dose is administrated within 6 months of the first, immunity against infection lasts for 3 years. The benefit of supplying one dose still outweighs no doses: although the temporary interruption of the two-dose strategy will lead to a reduction and shortening of immunity, this decision will allow more people to be vaccinated and provide them protection in the near term, should the global cholera situation continue deteriorating. The current supply of cholera vaccines is extremely limited. Its use for emergency response is coordinated by the ICG which manages the global stockpile of oral cholera vaccines. Of the total 36 million doses forecast to be produced in 2022, 24 million have already been shipped for preventive (17%) and reactive (83%) campaigns and an additional 8 million doses were approved by the ICG for the second round for emergency vaccination in 4 countries, illustrating the dire shortage of the vaccine. As vaccine manufactures are producing at their maximum current capacity, there is no short-term solution to increase production. The temporary suspension of the two-dose strategy will allow the remaining doses to be redirected for any needs for the rest of the year. This is a short-term solution but to ease the problem in the longer term, urgent action is needed to increase global vaccine production. The ICG will continue to monitor the global epidemiological trends as well as the status of the cholera vaccine stockpile, and will review this decision regularly. About the ICG The ICG is an international group that manages and coordinates the provision of emergency vaccine supplies and antibiotics to countries during major disease outbreaks. It manages the global stockpile of the oral cholera vaccine. The group is composed of members of WHO, Médecins Sans Frontières, UNICEF and the International Federation of Red Cross and Red Crescent Societies. The ICG was established in 1997, following major outbreaks of meningitis in Africa, as a mechanism to manage and coordinate the provision of emergency vaccine supplies and antibiotics to countries during major outbreaks. Since the establishment of the cholera vaccine stockpile in 2013, 120 million doses of oral cholera vaccine doses have been shipped to 23 countries, of which 73 million (60%) has been approved for emergency response. Media contacts IFRC: Jenelle Eli +41 79 935 97 40 +1 202 603 6803 [email protected] MSF: Lukas Nef  +41792400790 +41443859457 [email protected] UNICEF: Tess Ingram +1 347 593 2593 [email protected] WHO: WHO Media inquiries Telephone: +41 22 791 2222 Email: [email protected]

Immunization is the foundation of healthy communities. And right now, in the continued fight against COVID-19, vaccines are one of many important tools we have to keep communities around the world safe and healthy. The International Red Cross and Red Crescent Movement is supporting COVID-19 vaccination efforts in 172 countries. And, together, our National Societies have supported more than 325 million people to access COVID-19 vaccination globally. Since the start of the pandemic, we’ve made special efforts to reach vulnerable, marginalized and hard-to-reach communities worldwide. To go what we call the ‘last mile’—because all people, no matter who or where they are, deserve access to health services, vaccines, testing and lifesaving treatment. And because we know that no one is safe until everyone is safe. So, what does this work actually look like? Scroll down to discover photos and examples from five different countries: Papua New Guinea, Libya, Zambia, Kyrgyzstan and Canada. And if you like what you read, sign up to the IFRC’s immunization newsletter for a monthly round-up of immunization activities in response to COVID-19 and other diseases. Papua New Guinea Papua New Guineahas one of the lowest vaccination coverage rates in the world. The Papua New Guinea Red Cross is working closely with provincial health authorities in the rollout of COVID-19 vaccines, and a crucial part of this work involves building public confidence in vaccination. Volunteers are providing accurate, reliable and trusted public health information about COVID-19 vaccination. In many cases, they work in partnership with local community groups—such as the Country Women Association in Madang province—to reach people in spaces they already feel comfortable in. By listening and responding to people’s concerns about the vaccines, they are dispelling people’s fears and encouraging more and more people to come forward for their jab. Libya The Libyan Red Crescent Society is partnering with the Libyan National Centre for Disease Control to support the rollout of COVID-19 vaccination—with a focus on community engagement and logistical support. More than 600 volunteers have been going out and about in their communities to engage with local people and answer their questions about vaccines. Volunteers have been helping with vaccine registration and data entry, so people can sign up for their jabs, and several Libyan Red Crescent health clinics in the south of the country are currently being used as vaccination centres. Zambia Zambia Red Cross Society volunteers are running a mobile COVID-19 vaccination campaign to take vaccines out to remote and hard-to-reach communities across the country. They’re working with trusted local community leaders, helping them to be advocates for COVID-19 vaccines so that their communities feel confident coming forward. Volunteers are also working hard to continue routine immunization activities across the country so that all Zambian children are fully immunized before the age of 5. Kyrgyzstan Hundreds of Kyrgyzstan Red Crescent Society volunteers across the country have dedicated their time to supporting the Ministry of Health and Social Development’s rollout of COVID-19 vaccines. They set up a special COVID-19 vaccination hotline to answer the public’s questions and address rumours and misinformation about vaccines. And they’ve been deployed to vaccination centres to lead vaccine registration and data entry so people can easily schedule their appointments. Canada In Canada, the Canadian Red Crosshas been supporting provincial, territorial and Indigenous health authorities in vaccination efforts among remote and Indigenous communities. For instance, in Northern Alberta, CRC’s Indigenous staff have been embedded into mobile vaccination teams to help understand and address the roots of vaccine hesitancy. They’ve been supported virtually by an Indigenous People’s Help Desk, set up to respond to the unique needs of Indigenous leadership during the pandemic. -- For more information, visit our immunization page or sign up to the IFRC's monthly immunization newsletter.

Working in some of the world’s most challenging environments, the IFRC supports our 191 National Societies to reach vulnerable and isolated communities with life-saving vaccines.

Budapest, 5 March 2019 – Ukrainian Red Cross Society volunteers are being deployed to help contain a measles outbreak that has affected more than 75,000 people, making it the largest outbreak in Europe since 2015. This includes 54,000 measles cases reported in 2018, and more than 21,000 cases registered thus far in 2019. Poor immunization coverage has contributed to the measles outbreak in Ukraine. In 2018, the measles vaccination rate for newborn babies was only 54 per cent, which is amongst the lowest in the world. This is well below the target of 95 per cent recommended by the World Health Organization. A rate of 95 per cent would protect even those members of the community who cannot be vaccinated for medical reasons. Professor Mykola Polishchuk, Acting President of Ukrainian Red Cross Society, said: “Ukraine has one of the lowest vaccination rates against measles in the world and this is a very worrying trend. We are deploying 100 Red Cross volunteers to raise awareness about vaccination and conduct education campaigns to stop the spread of this disease.” The International Federation of Red Cross and Red Crescent Societies (IFRC) has released 109,000 Swiss francs from its Disaster Relief Emergency Fund to help the Ukrainian Red Cross Society tackle the outbreak. Officials say the low coverage rate and widespread transmission of the virus is due to many factors, including transport costs for those in rural areas, a high number of people with weakened immune systems, such people living with HIV and tuberculosis - and vaccine refusal. The funds will allow Ukrainian Red Cross Society to assist 90,000 people, including the most at-risk – children under six years of age, people with weakened immune systems, and people who have never been vaccinated against the disease. The emergency funds will also allow volunteers to help health authorities raise awareness about vaccination, to conduct education campaigns in kindergartens, schools, hospitals and aged care facilities, and to provide protective equipment for Red Cross volunteers. IFRC Europe Regional Director, Simon Missiri, said vaccine refusal is an increasingly worrying trend worldwide. “It is hard to believe that children are dying of measles in Europe in 2019,” he said. “This disease is almost completely preventable. Red Cross workers have an important role in helping communities understand the importance of vaccines, and in answering concerns that are increasingly prevalent in many countries.” The measles operation will run for four months in five regions across the country. Recent global declines in vaccination rates resulted in more than 110,000 measles deaths worldwide in 2017. The Ukraine outbreak coincides with other measles outbreaks across Europe and in the Philippines where measles cases are up more than 547 per cent in 2018 compared to 2017.