Health authorities in the Democratic Republic of the Congo (DRC) have announced plans to introduce a second experimental Ebola vaccine, manufactured by Johnson & Johnson, from mid-October 2019.
The vaccine, which is given as a two-dose course with a 56 day cycle, will be provided under approved protocols to targeted at-risk populations in areas that do not have active Ebola transmission, as an additional tool to extend protection against the virus.
The new vaccine will complement the current vaccine (rVSV-ZEBOV-GP, manufactured by Merck), which has proven highly effective and safe, and which has helped protect thousands of lives. The Merck vaccine will continue to be provided to all people at high risk of Ebola infection including those who have been in contact with a person confirmed to have Ebola, all contacts of contacts and others determined to be at high risk of contracting Ebola.
Over 223,000 people have received this vaccination during the current outbreak.
In May 2019, the World Health Organizations’ (WHO) Strategic Advisory Group of Experts on Immunization (SAGE) reviewed the use of vaccines in the ongoing Ebola outbreak and issued several recommendations, which included:
- adjusting the dose of the Merck vaccine
- evaluating a second vaccine under appropriate protocols
- changing strategies when insecurity makes it difficult to reach people
- increasing the number of people vaccinated within communities with ongoing transmission
The main vaccination strategy used with the Merck vaccine is a ‘ring strategy’ where all people who have come into contact with someone with a confirmed case of Ebola are given the vaccine. Where people are stigmatized or feel under threat, temporary ‘pop-up’ vaccination sites are set up, often at health posts, rather than near the homes of individuals infected with Ebola. In addition to providing vaccination access at a safe, more anonymous site, this strategy also increases protection for vaccinators in areas where there is ongoing conflict and insecurity.
Another approach being used to offer vaccination for people with a high-risk of contracting Ebola is ‘targeted geographic vaccination’. This involves vaccinating everyone in the neighbourhood, rather than vaccinating only the known contacts and contacts of contacts. Targeted geographic vaccination was used successfully when the outbreak spread to Chowe in South Kivu, with over 90% of people accepting vaccination.
Since the start of the outbreak, the WHO and its partners have worked to recruit and train Congolese nationals from within Ebola-affected communities as vaccinators to increase community acceptance and also transfer skills to the region. The majority of ring vaccination team members are now trained healthcare workers, doctors and medical students from affected communities who speak local languages and understand community concerns.
Source: WHO, 23 September 2019