The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) started vaccinating Ebola frontline workers yesterday in Bikoro, Equateur Province, Democratic Republic of Congo (DRC). The vaccination, which is being conducted with Epicentre--MSF's research arm--will also be offered to contacts of patients. The start of the Bikoro trial comes about a week after health care workers in Mbandaka began receiving the vaccine.
The vaccination trial--which is only one element of the larger strategy to control the spread of Ebola--will be administered using a "ring" approach. This involves identifying newly diagnosed and laboratory-confirmed Ebola patients, locating the people they have been in contact with--often family members, neighbors, colleagues, and friends--and vaccinating them. This type of approach aims to help contain and prevent the spread of infection.
This investigational vaccine (rVSVDG-ZEBOV-GP) has not yet been licensed and is being implemented through a study protocol, which has been accepted by national authorities and the Ethical Review Board in Kinshasa, as well as MSF's Ethical Review Board.
Participation in this vaccine trial is voluntary and free, participants receive information on the vaccine before consenting, and those who choose to be vaccinated are carefully monitored over a period of time. "Given that it has not yet been licensed, we will be closely monitoring the vaccination," said Micaela Serafini, MSF's medical director in Geneva.
In collaboration with the Ministry of Health, the World Health Organization (WHO), and other agencies, MSF and Epicentre were involved in vaccine trials in Conakry, Guinea, at the end of the 2015 Ebola outbreak in that country.
"Based on the results of these trials we are confident in using the vaccine for this current outbreak," Serafini said. "The results of the trial suggest that the vaccine will present a real benefit to people at high risk of contracting Ebola, protecting them against the infection."
Some of MSF's staff most experienced in Ebola response have worked with the DRC's Ministry of Health and the WHO over the past few weeks to develop and implement an outbreak response, including tracing people who have been in direct or indirect contact with confirmed Ebola cases and working with communities to raise awareness about how Ebola spreads and encourage safe burial practices.
"Vaccination remains just one additional tool in the fight against the disease," Serafini said. "Identifying patients and contacts is the first step."
People who are vaccinated in this trial will continue to follow the same infection control protocols. For example, Ebola health workers will continue wearing protective equipment, and teams are continuing to follow the necessary "pillars" of an Ebola intervention, including:
- Providing medical and psychological care and isolating people who are sick.
- Outreach activities including tracing and following up with contacts.
- Informing communities about the disease, how to prevent it, and where to seek care.
- Supporting existing healthcare structures.
- Temporarily adapting cultural behavior, such as funeral rites.
MSF is currently prepared to treat Ebola patients in Mbandaka, Bikoro, Itipo, and Iboko.