The World Health Organisation (WHO) has emphasised that an experimental vaccine is playing a major role in controlling the spread of Ebola in the ongoing outbreak in the Democratic Republic of Congo (DRC). Without the vaccine, the outbreak has the potential to spiral out of control, considering the country’s social and political landscape as well as the sheer ability of the virus to spread.
It’s clear that having a vaccine in use early in an epidemic is a significant breakthrough in the fight against this deadly disease. And yet, six months after the first case was diagnosed, the outbreak is still not contained and cases are being reported almost daily and occasionally spreading outwards.
Normally the DRC is well prepared and has substantive experience in dealing with Ebola. But a number of factors have hampered the current situation and made it hard to contain the outbreak – even for experienced frontier medical teams.
The epicentre of the outbreak was in North Kivu province. This lies in an active conflict zone and has very little infrastructure making it very difficult to administer enough of the vaccine to ensure immunity. In addition, health workers have been confronted with widespread violent unrest due to political instability in the country. A number of units had to be pulled out following attacks. Response rates were also slowed down following protests at the time of elections in December.
The vaccine rollout
The rVSV-ZEBOV vaccine is being tested in the DRC. It was first rolled out towards the end of the West Africa epidemic in Guinea in 2015. This was part of a phase III trial to evaluate the efficacy of the vaccine to prevent Ebola spreading among people.
Initial investigative data came from comparing a group of at-risk people who were vaccinated immediately after diagnosis of an Ebola virus case in their surrounding with a similar group of people who received the vaccine after a delay of 21 days.