Why is the oral cholera vaccine not considered an option for prevention of cholera in India? Analysis of possible reasons

Cholera has been for many centuries a permanent feature of life in the slums and poverty-stricken villages in India, particularly in the eastern regions of the country. In this region outbreaks have occurred frequently since the early 1800s1. The first six cholera pandemics originated from this geographical region while the seventh and ongoing pandemic originated in 1961 from Sulawasi in Indonesia. Most recent evidence indicates that within the seventh cholera pandemic two of the three waves of the El Tor biotype of Vibrio cholerae originated from the Gangetic delta off the Bay of Bengal2.