Vaccination against Ebola in the Democratic Republic of the Congo (DRC) will now be faster and more comprehensive, the World Health Organization (WHO) announced on Tuesday.
In response to what was characterized as "insecurity and community feedback," the WHO's Strategic Advisory Group of Experts (SAGE) issued for Ebola vaccination. The most recent on the Ebola outbreak in the DRC from the WHO, released on May 5, lists 1,572 cases and 1,045 deaths, for a 66% case fatality ratio. There were also 106 new cases, according to the most recent report. Despite this, more than 111,000 people have been vaccinated.
"We know that vaccination is saving lives in this outbreak," said WHO Director-General Tedros Adhanom Ghebreyesus, PhD, MSc, "We also know that we still face challenges in making sure the contacts of every case receive the vaccine as soon as possible. These recommendations account for ongoing insecurity and incorporate feedback from experts and from the affected communities that will help us continue to adapt the response."
New vaccination strategies are set to include both "pop-up" vaccination and targeted vaccination. Pop-up vaccination will be "implemented at an agreed and temporary, protected vaccination site, at a distance from the residence of the contacts, often a health facility," the authors said. Targeted vaccination will consist of all contacts, and contacts of cases, and will be done at a fixed location where security is provided.
"Besides addressing the security issues, this strategy allows the teams to catch up with the increased number of cases without vaccination rings in certain locations," the authors wrote.
In addition, SAGE proposed operational changes to the vaccination strategy, including the addition of a second vaccine: the adenovirus 26 vectored glycoprotein/MVA-BN (Ad26.ZEBOV/MVA-BN) vaccine developed by Johnson & Johnson. This vaccine will be offered to those at "some risk" of Ebola in health zones with "cases at a lower risk."
However, rVSV-ZEBOV-GP vaccine -- which has been the vaccine used throughout the outbreak -- will continue to be offered to health workers, front-line workers, and "those at higher risk" of contracting Ebola, including contacts, and contacts of contacts. This vaccine will also be offered to the third level of contacts to create a barrier around contacts of contacts in affected health zones, the authors noted.
"This approach also addresses community requests to offer vaccination to additional members of the community that they consider to be at high risk as they believe this is likely to increase overall community acceptability," the authors noted.