23 Jan 2015

What next in the fight against Ebola?

The first batch of GlaxoSmithKline’s experimental Ebola vaccine has been shipped to West Africa and is expected to arrive in Liberia later today, the British drugmaker says.

The shipment, containing an initial 300 vials of the candidate vaccine, is the first to arrive in one of the main Ebola affected countries and will be used to start the first large-scale vaccine trial of experimental Ebola vaccines in the coming weeks, GSK said in a statement.

Researchers hope eventually to enrol up to 30,000 people in the trial, a third of whom would get GSK’s candidate vaccine.

Read: Spike in Ebola outbreaks underlines danger of complacency

According to the company, clinical trials are taking place in the UK, US, Switzerland and Mali, involving around 200 healthy volunteers in total.

‘Major achievement’

Dr Moncef Slaoui, chairman of Global Vaccines at GSK, said: “Shipping the vaccine today is a major achievement and shows that we remain on track with the accelerated development of our candidate Ebola vaccine.

It could significantly contribute to efforts to bring this epidemic under control and prevent future outbreaks. Dr Moncef Slaoui

“The initial phase I data we have seen are encouraging and give us confidence to progress to the next phases of clinical testing which will involve the vaccination of thousands of volunteers, including frontline healthcare workers. If the candidate vaccine is able to protect these people, as we hope it will, it could significantly contribute to efforts to bring this epidemic under control and prevent future outbreaks.”

Professor Andrew Lee, a public health expert at the University of Sheffield:
It is indeed encouraging that a vaccine against Ebola has been developed within such a short time frame and if it proves to be effective it cannot come quickly enough. However, therein lies a key issue - is this vaccine going to be effective? Whilst the human trials carried out initially may show it is safe and generates an immune response, what is less clear is whether this immune response is sufficient to protect a person from an Ebola infection. Neither do we know for certain how long it takes for immunity to be generated or how long this immunity generated by the vaccine will last.

Even if the vaccine works, rolling out a vaccination programme nationally in the affected countries is no easy task. There may be public fears and misconceptions around vaccination that may act as barriers to uptake. There may be issues with the supply chain ensuring that the vaccine is stored and transported correctly to where it is needed. And there are issues ensuring that it is given in the right way to the right people who need it by staff appropriately trained to give the vaccine.his is even before we start counting the costs associated with the vaccines and vaccination programme required.

The initial limited vaccine supplies are probably best targeted at healthcare workers and for contacts of infected cases of Ebola in order to protect those most at risk of catching the disease and to limit the spread of the disease.

In the medium to longer term vaccination would certainly be a key method for tackling the Ebola epidemic. However, certainly for the next few months, existing disease control measures such as case identification and management, and infection control in healthcare and community settings are likely to remain the mainstay of what we can do.

Current signs are that the epidemic may have peaked and is starting to wain. Having an effective vaccine could help speed up its resolution and provide a longer term means of preventing it happening again."

The World Health Organisation said yesterday the Ebola outbreak in west Africa appears to be waning but cautioned against complacency in an epidemic that has seen 21,724 cases reported in nine countries since it started in Guinea a year ago. Some 8,641 people have died, according to WHO data.

Dr Slaoui cautioned that the vaccine is “still in developent”, adding: “Any potential future use in mass vaccination campaigns will depend on whether WHO, regulators and other stakeholders are satisfied that the vaccine candidate provides protection against Ebola without causing significant side effects and how quickly large quantities of vaccine can be made.”


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