Effective and easy to administer cholera vaccines are in need more than ever, 
for at risk populations and travellers alike. In many parts of the world cholera 
is still endemic, causing outbreaks and constituting repeatedly serious public 
health problems. The oral live cholera vaccine CVD 103-HgR (Orochol, Mutachol), 
the first genetically modified organism (GMO) used as vaccine, was in its time 
(launched 1993, Switzerland) the ideal cholera vaccine: single-dose, protective 
efficacy of 80-100% against moderate to severe cholera, acting within 8 days and 
exhibiting excellent safety, indiscernible from placebo. However, there were 
strong headwinds: In the 1990s the indication for cholera vaccines was generally 
downplayed by experts and in 1997 the European Commission called for a 
moratorium of GMOs which blocked the registration in the European Union. Thus, 
demand for this vaccine remained low and in 2003 it was taken off the market for 
economic reasons. After a decade in obscurity it (Vaxchora) has resurfaced 
again, now produced in the U.S. and equipped with a U.S. FDA license (June 10, 
2016). What had happened? This commentary gives a critical account of an almost 
unbelievable string of misadventures, emerging adverse circumstances and 
man-made failures which nearly killed this single-dose live oral cholera 
vaccine. The good news is that patience and persistence lead to success in the 
end, allowing good science to prevail for the benefit of those in need.