Second Ebola vaccine to be introduced as WHO accused of restricting access

Anne Gulland
A nurse prepares a vaccine against Ebola in Goma, DRC - AFP

Infectious disease experts have welcomed the decision by the Democratic Republic of Congo (DRC) to introduce a second Ebola vaccine to fight the long-running outbreak of this deadly disease. 

Earlier this year the DRC government ruled out the introduction of a second vaccine over concerns that it would “confuse” the public as this is given in two doses whereas the current one is given just once.

But experts said another vaccine was desperately needed because the current Merck vaccine is in short supply.

This vaccine is widely considered to have stopped the Ebola outbreak running completely out of control. As it is, there have been more than 3,000 cases including more than 2,000 deaths since the outbreak was first declared in August last year. 

Experts called for the introduction of the Johnson & Johnson (J&J) shot in case of a sudden increase in the number of cases or the disease spreads to other locations.

The J&J vaccine, given in two doses, 56 days apart, will be administered to people in areas where Ebola is not currently circulating as an “additional tool to extend protection against the virus”, said the World Health Organization in a statement.

“The DRC authorities, in deciding to deploy the second experimental vaccine to extend protection against this deadly virus, have once again shown leadership and their determination to end this outbreak as soon as possible,” said WHO director-general, Dr Tedros Adhanom Ghebreyesus.

Dr Jeremy Farrar, director of Wellcome, said: “The Merck vaccine has played a crucial role in keeping the current outbreak in the DRC from spiralling out of control. But it is vital that we have more than one Ebola vaccine ready and licensed, so that we can have options to be used in different settings, as well as a sustainable supply."

There are more than a million doses of the J&J vaccine and Merck says it will release a further 650,000 doses of its vaccine over the next six to 18 months.

To date 223,000 people have been vaccinated but Médecins Sans Frontières (MSF), an international non-governmental organisation at the forefront of the response, said WHO was restricting access and this is just a fraction of the number that should have received the vaccine.

The current vaccine is administered in a ring approach to the contacts and contacts of contacts of those with the disease, adding up to approximately 150 to 200 people per patient. With more than 3,000 confirmed cases that means that 450,000 to 600,000 people should have been vaccinated, says MSF. 

MSF said that WHO is imposing tight controls on supply and eligibility criteria meaning that only a small amount of people are being vaccinated. 

It said that a third of health workers in Beni – a hotspot of the outbreak – had reported not receiving the shot. 

Natalie Roberts, MSF emergency coordinator, said: “Medical teams should be able to rapidly provide treatments or vaccines based on what they see on the ground. But our capacity to carry out real-time assessments and react accordingly is severely undermined by a rigid system which is hard to comprehend. 

“It’s like giving firefighters a bucket of water to put out a fire, but only allowing them to use one cup of water a day. Every day we see known contacts of confirmed Ebola patients who have not received their dose despite being eligible for vaccination." 

Mike Ryan, executive director of WHO's emergencies programme, said: “We partner closely with the DRC government to reach as many communities and individuals in the outbreak area as possible and are not limiting access to vaccine but rather implementing a strategy recommended by an independent advisory body of experts and as agreed with the government of the DRC and partners.”

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