Opinion Pieces Discuss Ebola Vaccination Strategies, Research

STAT: An ‘indefensible’ decision: not vaccinating pregnant and lactating women in an Ebola outbreak
Ruth R. Faden, founder and inaugural director of the Johns Hopkins Berman Institute of Bioethics; Ruth A. Karron, director of the Center for Immunization Research and director of the Johns Hopkins Vaccine Initiative; and Carleigh Krubiner, policy fellow at the Center for Global Development

“…[A]n experimental vaccine called rVSV-ZEBOV has been shown to be highly effective against [the Zaire] strain of Ebola virus. The DRC’s ministry of health, along with WHO and partners, has already begun employing the vaccine using the highly successful ring vaccination strategy, in which contacts and contacts-of-contacts of people with Ebola are offered the vaccine to halt the spread of the disease. Some contacts, though, won’t get the vaccine. Pregnant women and those who are lactating are being excluded from this life-saving intervention. From a public health perspective and an ethical perspective, the decision to exclude pregnant and lactating women is utterly indefensible. … Continued exclusion of pregnant and lactating women from the Ebola vaccine response would be profoundly unfair — and profoundly unwise. The DRC ministry of health and the WHO must recognize that women who are pregnant or lactating and who are contacts of Ebola patients must be given equal treatment. They are as entitled as any other contacts to the lifesaving benefits of the rVSV-ZEBOV vaccine” (8/27).

The Lancet: Prevention of Ebola virus disease through vaccination: where we are in 2018
Yves Lévy, CEO of the French Institute for Health and Medical Research, and colleagues

“…To build on the vaccine research studies that have been done thus far, the outstanding questions on the rapidity and durability of the immune response in adults, safety and immunogenicity in children, and the nature of the responses in immunocompromised and pregnant individuals using different vaccine strategies must be addressed. … Answering these questions will require improvement of global capacity to continue research on Ebola vaccines, and collaborative partnerships are needed to optimize the chances of success. … [I]t is important to investigate different scenarios for vaccination strategies and different vaccines to respond more effectively to future outbreaks. These strategies include contact and post-exposure vaccination, targeted preventive vaccination, and widespread preventive vaccination of at-risk populations such as health care workers and those residing in areas of recurrent outbreaks” (8/10).