{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T11:51:24Z","timestamp":1782906684577,"version":"3.54.5"},"reference-count":58,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"WellcomeTrust","award":["221586\/Z\/20\/Z"],"award-info":[{"award-number":["221586\/Z\/20\/Z"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background\/Objectives: Cholera remains an important global health problem. Inactivated oral cholera vaccines (OCVs) are essential in the WHO\/GTFCC (World Health Organization\/Global Task Force on Cholera Control) strategy to end cholera by 2030; however, global supply is insufficient, they require partial cold-chain storage, and their formulation and antigen contents leave room for improvement. We describe here the development and preclinical evaluation of DuoChol OCV, a next-generation thermostable oral vaccine designed to address these gaps. Methods: DuoChol is a lyophilized dry-powder formulation in enteric capsules containing formalin-inactivated Vibrio cholerae O1 El Tor Ogawa and Inaba isogenic bacteria, recombinant cholera toxin B subunit (rCTB), and sucrose as stabilizer. Methods describe the construction of the novel vaccine strains, processes for the preparation and characterization of vaccine components, and the final dry formulation in enteric capsules, and in vitro and in vivo vaccine stability analyses. Results: The newly engineered vaccine strains, together with a high-yield mixed-mode chromatography process for rCTB purification, enabled efficient and cost-effective vaccine production. Stability studies demonstrated complete preservation of O1 LPS and rCTB antigens for at least 21 months across temperatures of 4\u201340 \u00b0C. Moreover, regardless of storage duration or temperature, oral immunization of mice with DuoChol elicited strong serum and mucosal antibacterial and antitoxin responses that were similar to those induced by the licensed Dukoral\u00ae OCV. Conclusions: Its heat stability, practical enteric capsule formulation, and potential for improved efficacy compared to inactivated whole-cell only OCVs support positioning DuoChol as a promising next-generation OCV, suitable for national cholera control programs and particularly advantageous for outbreak response, where rapid deployment and early, robust protection are essential.<\/jats:p>","DOI":"10.3390\/vaccines14070573","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:55:11Z","timestamp":1782780911000},"page":"573","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development of DuoChol, a Thermostable Inactivated Whole-Cell\/B-Subunit Oral Cholera Vaccine in Enteric Capsule"],"prefix":"10.3390","volume":"14","author":[{"given":"Manuela","family":"Terrinoni","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology, Gothenburg University Vaccine Research Institute (GUVAX), Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Box 435, 405 30 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Lebens","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Gothenburg University Vaccine Research Institute (GUVAX), Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Box 435, 405 30 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan L.","family":"Nordqvist","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Gothenburg University Vaccine Research Institute (GUVAX), Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Box 435, 405 30 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frida","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Gothenburg University Vaccine Research Institute (GUVAX), Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Box 435, 405 30 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"L\u00f6fstrand","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Gothenburg University Vaccine Research Institute (GUVAX), Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Box 435, 405 30 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Lynch","sequence":"additional","affiliation":[{"name":"International Vaccine Institute (IVI), Seoul 08826, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Holmgren","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Gothenburg University Vaccine Research Institute (GUVAX), Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Box 435, 405 30 Gothenburg, Sweden"},{"name":"Gotovax AB, 426 74 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"ref_1","unstructured":"(2024, March 07). Diarrhoeal Disease Fact Sheet. World Health Organization. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/diarrhoeal-disease."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1016\/S0140-6736(22)00330-0","article-title":"Cholera","volume":"399","author":"Kanungo","year":"2022","journal-title":"Lancet"},{"key":"ref_3","unstructured":"WHO (2024, December 04). Multi-Country Outbreak of Cholera ESR. Available online: https:\/\/www.who.int\/publications\/m\/item\/multi-country-outbreak-of-cholera--external-situation-report--17---15-august-2024."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"221","DOI":"10.2166\/wh.2026.233","article-title":"Recurrent outbreaks of cholera in Nigeria: A narrative review on the role of conflict and climate change","volume":"24","author":"Gulumbe","year":"2026","journal-title":"J. Water Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"11786302261431135","DOI":"10.1177\/11786302261431135","article-title":"Climate Variability, Urbanization, Water Insecurity, and Cholera in Somalia (2000\u20132025): A Thematic Narrative Review","volume":"20","author":"Ahmed","year":"2026","journal-title":"Environ. Health Insights"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Muvunyi, C.M., Siddig, E.E., Ali, E.T.O., Iradukunda, P.G., Gashema, P., de Dieu Harelimana, J., Mazaba, M.L., and Kaseya, J. (2026). Cholera in Africa: Current trends, challenges, and control towards elimination strategies. PLoS Negl. Trop. Dis., 20.","DOI":"10.1371\/journal.pntd.0014325"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Hassen, J., Bekele, M., Botore, A., Mannekulih, E., Kenate, B., Kibebew, T., Bafikadu, C., Zewdie, A., Worku, D., and Shumi, G. (2026). Serotype and antimicrobial susceptibility patterns of Vibrio cholerae in cholera outbreak areas of East and Central Oromia Region, Ethiopia, 2024. BMC Infect. Dis.","DOI":"10.1186\/s12879-026-13580-4"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1080\/08998280.2026.2615555","article-title":"Recent epidemiological and management approaches for cholera in India","volume":"Volume 39","author":"Havelikar","year":"2026","journal-title":"Baylor University Medical Center Proceedings"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Luangnara, A., Towachiraporn, S., Wiwatkunupakarn, N., and Thongwitokomarn, H. (2026). Impact of flooding events on waterborne and vector-borne infections: A systematic review. BMC Infect. Dis., 26.","DOI":"10.1186\/s12879-026-13442-z"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"102985","DOI":"10.1016\/j.tmaid.2026.102985","article-title":"Climate change, migration, and infectious disease vulnerability at Europe\u2019s southern border: Lampedusa as a sentinel interface","volume":"71","author":"Accurso","year":"2026","journal-title":"Travel Med. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"128571","DOI":"10.1016\/j.vaccine.2026.128571","article-title":"Improving cholera vaccination impact through advances in gut mucosal immunology: Outcomes of a 2025 expert consultation","volume":"81","author":"Lundgren","year":"2026","journal-title":"Vaccine"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Holmgren, J. (2021). An Update on Cholera Immunity and Current and Future Cholera Vaccines. Trop. Med. Infect. Dis., 6.","DOI":"10.3390\/tropicalmed6020064"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Ryan, E.T., Leung, D.T., Jensen, O., Weil, A.A., Bhuiyan, T.R., Khan, A.I., Chowdhury, F., LaRocque, R.C., Harris, J.B., and Calderwood, S.B. (2021). Systemic, Mucosal, and Memory Immune Responses following Cholera. Trop. Med. Infect. Dis., 6.","DOI":"10.3390\/tropicalmed6040192"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1038\/nri3251","article-title":"Recent progress in mucosal vaccine development: Potential and limitations","volume":"12","author":"Lycke","year":"2012","journal-title":"Nat. Rev. Immunol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e0056523","DOI":"10.1128\/msphere.00565-23","article-title":"Cholera toxin and O-specific polysaccharide immune responses after oral cholera vaccination with Dukoral in different age groups of Bangladeshi participants","volume":"9","author":"Dash","year":"2024","journal-title":"mSphere"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.vaccine.2016.11.055","article-title":"Kinetics of antibody-secreting cell and fecal IgA responses after oral cholera vaccination in different age groups in a cholera endemic country","volume":"35","author":"Akhtar","year":"2017","journal-title":"Vaccine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1078\/1438-4221-00241","article-title":"Role of secretory antibodies in the defence against infections","volume":"293","author":"Brandtzaeg","year":"2003","journal-title":"Int. J. Med. Microbiol."},{"key":"ref_18","unstructured":"WHO: World Health Organization (2017). Cholera vaccines: WHO position paper. Wkly. Epidemiol. Rec., 92, 477\u2013500."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Song, K.R., Lim, J.K., Park, S.E., Saluja, T., Cho, S.I., Wartel, T.A., and Lynch, J. (2021). Oral Cholera Vaccine Efficacy and Effectiveness. Vaccines, 9.","DOI":"10.3390\/vaccines9121482"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/S0140-6736(05)66550-6","article-title":"Herd immunity conferred by killed oral cholera vaccines in Bangladesh: A reanalysis","volume":"366","author":"Ali","year":"2005","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ali, M., and Clemens, J. (2019). Assessing Vaccine Herd Protection by Killed Whole-Cell Oral Cholera Vaccines Using Different Study Designs. Front. Public Health, 7.","DOI":"10.3389\/fpubh.2019.00211"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1016\/S0140-6736(17)30559-7","article-title":"Cholera","volume":"390","author":"Clemens","year":"2017","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Large, K., Ruiz, A.A., Slovenski, I., Vieira, M., and Moon, S. (2025). The 30-year evolution of oral cholera vaccines: A case study of a collaborative network alternative innovation model. PLoS Glob. Public Health, 5.","DOI":"10.1371\/journal.pgph.0003599"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e1203","DOI":"10.1016\/S2214-109X(25)00107-X","article-title":"Protection from killed whole-cell cholera vaccines: A systematic review and meta-analysis","volume":"13","author":"Xu","year":"2025","journal-title":"Lancet Glob. Health"},{"key":"ref_25","first-page":"CD014573","article-title":"Oral killed cholera vaccines for preventing cholera","volume":"1","author":"Mamun","year":"2024","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_26","first-page":"101500","article-title":"5-Year effectiveness of an oral cholera vaccine in a cholera outbreak in rural Haiti: A case-control study","volume":"60","author":"Ivers","year":"2026","journal-title":"Lancet Reg. Health Am."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1038\/s41591-024-02852-8","article-title":"Enhanced cholera surveillance to improve vaccination campaign efficiency","volume":"30","author":"Xu","year":"2024","journal-title":"Nat. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1016\/S1473-3099(17)30359-6","article-title":"Protection against cholera from killed whole-cell oral cholera vaccines: A systematic review and meta-analysis","volume":"17","author":"Bi","year":"2017","journal-title":"Lancet Infect. Dis."},{"key":"ref_29","unstructured":"(2022, October 19). 2022 WHO: Shortage of Cholera Vaccines Leads to Temporary Suspension of Two-Dose Strategy, as Cases Rise Worldwide. Available online: https:\/\/www.who.int\/news\/item\/19-10-2022-shortage-of-cholera-vaccines-leads-to-temporary-suspension-of-two-dose-strategy--as-cases-rise-worldwide."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/S1473-3099(18)30108-7","article-title":"Efficacy of a single-dose regimen of inactivated whole-cell oral cholera vaccine: Results from 2 years of follow-up of a randomised trial","volume":"18","author":"Qadri","year":"2018","journal-title":"Lancet Infect. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"288","DOI":"10.3201\/eid3102.241777","article-title":"Epidemiologic and Genomic Surveillance of Vibrio cholerae and Effectiveness of Single-Dose Oral Cholera Vaccine, Democratic Republic of the Congo","volume":"31","author":"George","year":"2025","journal-title":"Emerg. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1960","DOI":"10.1093\/cid\/cix1039","article-title":"Immunogenicity and Protection From a Single Dose of Internationally Available Killed Oral Cholera Vaccine: A Systematic Review and Metaanalysis","volume":"66","author":"Lopez","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e826","DOI":"10.1016\/S2214-109X(24)00059-7","article-title":"Safety and immunogenicity of the Euvichol-S oral cholera vaccine for prevention of Vibrio cholerae O1 infection in Nepal: An observer-blind, active-controlled, randomised, non-inferiority, phase 3 trial","volume":"12","author":"Song","year":"2024","journal-title":"Lancet Glob. Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"126998","DOI":"10.1016\/j.vaccine.2025.126998","article-title":"A double-blind, randomised phase III clinical trial to evaluate safety, immunogenicity, non-inferiority & lot to lot consistency of single component oral cholera vaccine BBV131 (Hillchol(R)) in comparison to Shanchol","volume":"55","author":"Vadrevu","year":"2025","journal-title":"Vaccine"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/S0140-6736(86)91944-6","article-title":"Field trial of oral cholera vaccines in Bangladesh","volume":"2","author":"Clemens","year":"1986","journal-title":"Lancet"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1093\/infdis\/158.2.372","article-title":"Cross-protection by B subunit-whole cell cholera vaccine against diarrhea associated with heat-labile toxin-producing enterotoxigenic Escherichia coli: Results of a large-scale field trial","volume":"158","author":"Clemens","year":"1988","journal-title":"J. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3347","DOI":"10.1016\/j.vaccine.2023.04.004","article-title":"A thermostable, dry formulation inactivated Hikojima whole cell\/cholera toxin B subunit oral cholera vaccine","volume":"41","author":"Terrinoni","year":"2023","journal-title":"Vaccine"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"7998","DOI":"10.1016\/j.vaccine.2020.10.043","article-title":"Development of Hillchol\u00ae, a low-cost inactivated single strain Hikojima oral cholera vaccine","volume":"38","author":"Sharma","year":"2020","journal-title":"Vaccine"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1006\/abio.1996.0048","article-title":"A rapid formaldehyde assay using purpald reagent: Application under periodation conditions","volume":"234","author":"Quesenberry","year":"1996","journal-title":"Anal. Biochem"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e02143-17","DOI":"10.1128\/AEM.02143-17","article-title":"A novel non-antibiotic, lgt-based selection system for stable maintenance of expression vectors in Escherichia coli and Vibrio cholerae","volume":"84","author":"Terrinoni","year":"2017","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_41","unstructured":"Sharma, T., Joshi, N., Kanchan, V., Sikriwal, D., Shukla, N., and Gill, D. (2017). A Novel Process for Production of Purified Recombinant Cholera Toxin b (rCTB) and Formulation Thereon. (International Patent Application WO2017103748A1), Available online: https:\/\/patents.google.com\/patent\/WO2017103748A1."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1128\/jcm.17.4.596-600.1983","article-title":"Rapid GM1-enzyme-linked immunosorbent assay with visual reading for identification of Escherichia coli heat-labile enterotoxin","volume":"17","author":"Svennerholm","year":"1983","journal-title":"J. Clin. Microbiol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Karlsson, S.L., Ax, E., Nygren, E., Kallgard, S., Blomquist, M., Ekman, A., Benktander, J., Holmgren, J., and Lebens, M. (2014). Development of stable Vibrio cholerae O1 Hikojima type vaccine strains co-expressing the Inaba and Ogawa lipopolysaccharide antigens. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0108521"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.2353\/ajpath.2008.070776","article-title":"Genetically programmed biases in Th1 and Th2 immune responses modulate atherogenesis","volume":"172","author":"Schulte","year":"2008","journal-title":"Am. J. Pathol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2192","DOI":"10.1128\/iai.58.7.2192-2197.1990","article-title":"Repertoires of antibodies to culture filtrate antigens in different mouse strains infected with Mycobacterium bovis BCG","volume":"58","author":"Huygen","year":"1990","journal-title":"Infect. Immun."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1017\/S003118200005099X","article-title":"The inheritance of responses to schistosomiasis mansoni in two pairs of inbred strains of mice","volume":"90","author":"Jones","year":"1985","journal-title":"Parasitology"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/BF01572591","article-title":"Genetics of the anti-dextran B512 and the autoanti-idiotypic response: Codominant expression in F1 hybrids and dichotomy of response and allotype-linked idiotype","volume":"10","author":"Fernandez","year":"1980","journal-title":"Immunogenetics"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1093\/toxsci\/58.2.299","article-title":"Influence of MHC background on the antibody response to detergent enzymes in the mouse intranasal test","volume":"58","author":"Sarlo","year":"2000","journal-title":"Toxicol. Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1782","DOI":"10.4049\/jimmunol.125.4.1782","article-title":"Genetic control of the immune response to collagen. III. Coordinate restriction of cellular cooperation and antigen responsiveness by thymus-directed maturation","volume":"125","author":"Hedrick","year":"1980","journal-title":"J. Immunol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1006\/abio.1998.2961","article-title":"Quantification of bacterial lipopolysaccharides by the purpald assay: Measuring formaldehyde generated from 2-keto-3-deoxyoctonate and heptose at the inner core by periodate oxidation","volume":"267","author":"Lee","year":"1999","journal-title":"Anal. Biochem."},{"key":"ref_51","first-page":"383","article-title":"Sensitive microplate assay for detection of bactericidal antibodies to Vibrio cholerae O139","volume":"9","author":"Attridge","year":"2002","journal-title":"Clin. Diagn. Lab. Immunol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.ejpb.2011.06.009","article-title":"Preparation and evaluation of a freeze-dried oral killed cholera vaccine formulation","volume":"79","author":"Borde","year":"2011","journal-title":"Eur. J. Pharm. Biopharm."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"114962","DOI":"10.1016\/j.ejpb.2025.114962","article-title":"Utilizing the dynamic gastrointestinal model (DGM) to evaluate the gastric integrity of Capsugel(R) Enprotect(R) capsules in fasted and fed states","volume":"219","author":"Knopp","year":"2026","journal-title":"Eur. J. Pharm. Biopharm."},{"key":"ref_54","unstructured":"CEPI: Coalition for Epidemic Preparedness Innovations (2022, February 03). Call for Proposals: Innovative Technologies to Improve Vaccine Thermostability. Available online: https:\/\/cepi.net\/news_cepi\/cepi-opens-call-to-develop-heat-stable-vaccine-tech-for-use-against-epidemic-and-pandemic-threats\/."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1093\/infdis\/158.1.60","article-title":"Field trial of oral cholera vaccines in Bangladesh: Results of one year of follow-up","volume":"158","author":"Clemens","year":"1988","journal-title":"J. Infect. Dis."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Grimm, M., Rump, A., Kromrey, M.L., Morof, F., Dumont, C., Jannin, V., Tzvetkov, M.V., and Weitschies, W. (2023). In Vivo Evaluation of a Gastro-Resistant Enprotect((R)) Capsule under Postprandial Conditions. Pharmaceutics, 15.","DOI":"10.3390\/pharmaceutics15112576"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Spasenoska, D., Kahn, A.L., Bouhenia, M., D\u2019Cor, N.A., Lee, J.S., Park, S.E., and Lynch, J. (2025). Uptake likelihood assessment of oral cholera vaccine capsules: Insights from stakeholder consultations in five countries. BMC Public Health, 25.","DOI":"10.1186\/s12889-025-25073-1"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"3135","DOI":"10.1016\/j.vaccine.2017.03.081","article-title":"Economic impact of thermostable vaccines","volume":"35","author":"Lee","year":"2017","journal-title":"Vaccine"}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/14\/7\/573\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T11:25:41Z","timestamp":1782905141000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/14\/7\/573"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,29]]},"references-count":58,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["vaccines14070573"],"URL":"https:\/\/doi.org\/10.3390\/vaccines14070573","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,29]]}}}