Cholera infects 3-5 million people a year and 100,000-120,000 people die from this disease each year, mainly the very young and the elderly. Current oral cholera vaccines provide fairly-effective short-term protection against infection in adults, but protection in children is modest and these vaccines do not result in long-term immunity. A new cholera vaccine invented by investigators from Massachusetts General Hospital, the International Centre for Diarrhoeal Disease Research, the National Institutes of Health and the FDA, utilizes the O-specific polysaccharide (OSP) of V. cholerae O1 El Tor Inaba serotype as an antigen, which is conjugated through the inner core via squarate chemistry to a recombinant tetanus toxoid heavy chain fragment. This vaccine has the ability to induce memory B cell responses, which currently-approved and development-stage oral vaccines do not, giving it the potential to induce long-term immunity in infants and children. A project funded by the National Institutes of Health to successfully produce a pilot lot of the vaccine candidate utilizing scalable manufacturing approaches is near completion. When completed, the candidate vaccine will be ready to graduate to a second stage of manufacturing development where a small lot of vaccine will be made for advanced preclinical development toward a first-in-human study.