(Health & Drugs)
HOPES HAVE BEEN RAISED in the experimental trials of the expectant EBOLA Vaccine among selected people in Guinea, 2015.
The outcome of the prospect of a protective vaccine against the deadly EBOLA Virus Disease which ravaged six countries of West Africa in 2014 was published in The Lancet on Friday.
The vaccine which is the first to prevent infection from one of the most lethal known pathogens, has reportedly added weight to early trial results that were recorded in the 2015 trials.
The vaccine, called rVSV-ZEBOV, was studied in a trial involving 11 841 people in Guinea during 2015.
Among the 5837 people who reportedly received the vaccine, no Ebola cases were recorded 10 days or more after vaccination.
In comparison, there were 23 cases 10 days or more after vaccination among those who did not receive the vaccine.
The trial was led by WHO, together with Guinea’s Ministry of Health, Medecins sans Frontieres and the Norwegian Institute of Public Health, in collaboration with other international partners.
Speaking on the cheering news, World Health Organisation (WHO) Assistant Director-General for Health Systems and Innovation, and the study’s lead author, Dr Marie-Paule Kieny noted: “While these compelling results come too late for those who lost their lives during West Africa’s Ebola epidemic, they show that when the next Ebola outbreak hits, we will not be defenceless”.
The vaccine’s manufacturer, Merck, Sharpe & Dohme, this year received Breakthrough Therapy Designation from the United States Food and Drug Administration and PRIME status from the European Medicines Agency, enabling faster regulatory review of the vaccine once it is submitted.
Since Ebola virus was first identified in 1976, sporadic outbreaks have been reported in Africa. But the 2013–2016 West African Ebola outbreak, which resulted in more than 11 300 deaths, highlighted the need for a vaccine.
The trial took place in the coastal region of Basse-Guinée, the area of Guinea still experiencing new Ebola cases when the trial started in 2015. The trial used an innovative design, a so-called “ring vaccination” approach – the same method used to eradicate small pox.
To assess safety, people who received the vaccine were observed for 30 minutes after vaccination, and at repeated home visits up to 12 weeks later. Approximately half reported mild symptoms soon after vaccination, including headache, fatigue and muscle pain but recovered within days without long-term effects.
Two serious adverse events were judged to be related to vaccination (a febrile reaction and one anaphylaxis) and one was judged to be possibly related (influenza-like illness). All three recovered without any long term effects.
It was not possible to collect biological samples from people who received the vaccine in order to analyse their immune response. Other studies are looking at the immune response to the vaccine including one conducted in parallel to the ring trial among frontline Ebola workers in Guinea.
“This both historical and innovative trial was made possible thanks to exemplary international collaboration and coordination, the contribution of many experts worldwide, and strong local involvement,” said Dr John-Arne Røttingen, specialist director at the Norwegian Institute of Public Health, and the chairman of the study steering group.
In January, GAVI, the Vaccine Alliance provided US$5 million to Merck towards the future procurement of the vaccine once it is approved, prequalified and recommended by WHO. As part of this agreement, Merck committed to ensure that 300 000 doses of the vaccine are available for emergency use in the interim, and to submit the vaccine for licensure by the end of 2017. Merck has also submitted the vaccine to WHO’s Emergency Use and Assessment Listing procedure, a mechanism through which experimental vaccines, medicines and diagnostics can be made available for use prior to formal licensure.
Additional studies are ongoing to provide more data on the safety of the vaccine in children and other vulnerable populations such as people with HIV. In case of Ebola flare-ups prior to approval, access to the vaccine is being made available through a procedure called “compassionate use” that enables use of the vaccine after informed consent. Merck and WHO’s partners are working to compile data to support license applications.
The rapid development of rVSV-EBOV contributed to the development of WHO’s R&D Blueprint, a global strategy to fast-track the development of effective tests, vaccines and medicines during epidemics.