WHO and Partners Launch Second Cholera Vaccine Dose to Safeguard Young Rohingya Refugees in Cox’s Bazar

On 27 April 2025, the World Health Organization (WHO), in collaboration with the Government of Bangladesh and health sector partners, launched the second-round of a targeted Oral Cholera Vaccination (OCV) campaign in Cox’s Bazar. This initiative aims to administer a second dose of the vaccine to Rohingya refugee children aged 1 to 5 years, building on the success of the initial mass vaccination campaign conducted earlier this year. Running from April 27 to 30, 2025, the second phase is focused on strengthening immunity among the youngest and most vulnerable population.

Cholera surveillance data collected between June 29, 2024, and January 29, 2025, during the outbreak period, revealed that children aged 1 to 5 years accounted for 39% (226 of 581) of reported cases. This highlights the urgent need to strengthen immunity in this vulnerable group. In response, approximately 166,661 refugee children are being targeted for the second dose in the vaccination round.

"As a Community Health Worker, I see firsthand the difference each vaccine makes. Parents are eager to protect their children, and this second dose gives them renewed hope for a healthier future," said Rahima Begum, a Community Health Worker supporting the OCV campaign in Cox’s Bazar. 

According to epidemiological updates from the WHO based on the Early Warning, Alert and Response System (EWARS), young children remain at the highest risk of cholera in refugee settings.

"Protecting the health of our youngest and most vulnerable remains our top priority. The second-dose campaign reflects Bangladesh’s unwavering commitment to preventing cholera outbreaks and safeguarding the future of Rohingya children," said Dr Samsad Rabbani Khan, Deputy Programme Manager (ARC, Viral Hepatitis and Diarrhoea Control Program), CDC, DGHS, Bangladesh.

The initial OCV campaign was conducted from January 12 to 19, 2025, across the Cox’s Bazar and Bandarban districts, and from January 27 to 30, 2025, on Bhasan Char Island. A total of 1,433,767 doses were administered from the 1,635,600 doses supplied by the International Coordinating Group (ICG) on Oral Cholera Vaccine Provision for Cholera Control. The vaccine deployment followed an approved request by the Directorate General of Health Services, Communicable Disease Control (DGHS-CDC), with operational support from GAVI, the Vaccine Alliance.

"Every vaccine administered is a step toward stronger community protection. By building on the success of the first campaign, we are not just delivering doses, we are delivering security, resilience, and a shield against future cholera threats," said Dr Sujit Paul, WHO National Professional Officer, Immunisation, Cox’s Bazar Sub Office.

Following the first campaign, 177,262 unused vaccine doses were safely stored at the Cox’s Bazar EPI Store under the supervision of the District Civil Surgeon. Vaccine wastage was limited to just 2% (24,571 doses), reflecting strong coordination, effective cold chain management, and logistical efficiency. The availability of these remaining doses enabled the rapid organisation of a second, targeted vaccination campaign, focusing specifically on children under five, the group most affected by recent cholera outbreaks.

By the end of the first day of the second-dose campaign (27 April 2025), 69,417 Rohingya children had been vaccinated, achieving 41.7% of the overall target. On the second day, an additional 134,909 children received the vaccine, bringing cumulative coverage to 80.9% of the targeted population.

"The success of this second-dose campaign underscores the strength of collaboration between the government, our partners, and the local communities. Together, we are filling critical gaps, boosting immunity, and ensuring every child is protected in the fight against cholera," said Dr Jorge Martinez, Head of WHO Sub-Office, Cox’s Bazar.

Oral cholera vaccination remains a vital strategy for cholera prevention, particularly in high-risk settings such as Cox’s Bazar, where overcrowded living conditions and limited access to safe water and sanitation significantly increase the risk of disease outbreaks.

Ensuring that young children receive the recommended two doses of the OCV is essential for strengthening long-term immunity and supporting broader efforts to control cholera transmission among refugee populations and surrounding host communities. Oral cholera vaccines have been proven to offer effective short- to medium-term protection, lasting up to three years.

Through evidence-based planning, strong multi-sectoral collaboration, and sustained community engagement, WHO and its health sector partners remain committed to protecting the health, resilience, and dignity of vulnerable populations in Cox’s Bazar and beyond.