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Ebola Vaccine Expectations


Guest post by Emily McFadden.

The New England Journal Medicine (NEJM) published a preliminary report last week presenting the initial clinical development of a potential Zaire strain-specific Ebola vaccine that will be available early next year. GlaxoSmithKline (GSK) and the U.S. National Institute of Allergy and Infectious Disease (NIAID) are developing the vaccine. The results of the phase I clinical trials, however, were gathered from labs worldwide.

Developers, however, already met obstacles as they pushed the vaccine into clinical phase. Leaders of Doctors Without Borders (MSF) and GSK butted heads at World Health Organizaion (WHO) headquarters in Geneva during a meeting about Ebola vaccines this September. MSF leaders argued that clinical trials should include only health workers on the frontline treating infected individuals. This strategy would not only provide data, but also potentially help the most at-risk individuals. GSK heads replied that this plan wouldn’t provide representative data, thus yielding a poor sample for further research.

This argument embodies the fundamental differences in organizational priorities, and is likely to resurface as the distribution date approaches. An estimated 10,000 trial vaccines will be distributed throughout West Africa in January 2015. How they are distributed will affect their evaluative results, and thus further development. Added factors, such as frequency, duration, and intensity of exposure, will also influence trial outcomes, so getting an illustrative sample is crucial. Additionally, MSF and GSK will need to cooperate with West African governments. How will they compromise so that further research and development isn’t hindered and lives aren’t lost? The longer the vaccine trial distribution takes, the more lives could be lost in the short term; but what about the long term effects of rushing an untested vaccine?

These preliminary distributions are just one step in the vaccine’s multi-phase development, but the next steps—evaluation of its effectiveness and side effects—are essential. Authorities pushed the 2009 Swine Flu Virus (H1N1) vaccine forward, resulting in reports of negative long-term effects, even though the immediate side effects were as expected. Vaccine development not only includes research, but also allows for longitudinal clinical studies. Ideally, there won’t be any long-term effects from the Ebola vaccine. But because the effects cannot be predicted, authorities should create a safety net for the scientists working on the vaccine to protect them from public backlash as well as a plan for the inoculated individuals if complications arise. Hopefully, the vaccine will be improved over time and the loss of life will be mitigated.

Emily McFadden is pursuing a PhD in Biochemistry at Duke University.