Effectiveness of rVSV-ZEBOV vaccination during the 2018–20 Ebola virus disease epidemic in the Democratic Republic of the Congo: a retrospective test-negative study - 28/11/24
, Justus Nsio, MD b, *, Anton Camacho, PhD a, Richard Kitenge, MD c, Rebecca M Coulborn, MPH a, Etienne Gignoux, MPH a, John Johnson, MSN e, Esther Sterk, MD MIH f, Elisabeth Mukamba Musenga, MD d, Stephane Hans Bateyi Mustafa, PhD g, h, i, Epicentre-MSF EVD Working Group
Flavio Finger, PhD a, †, Steve Ahuka-Mundeke, ProfMD PhD j, k, †Summary |
Background |
The recombinant vesicular stomatitis virus–Zaire Ebola virus (rVSV-ZEBOV) vaccine is the only WHO prequalified vaccine recommended for use to respond to outbreaks of Ebola virus (species Zaire ebolavirus) by WHO’s Strategic Advisory Group of Experts on Immunization. Despite the vaccine’s widespread use during several outbreaks, no real-world effectiveness estimates are currently available in the literature.
Methods |
We conducted a retrospective test-negative analysis to estimate effectiveness of rVSV-ZEBOV vaccination against Ebola virus disease during the 2018–20 epidemic in the Democratic Republic of the Congo, using data on suspected Ebola virus disease cases collected from Ebola treatment centres. Those eligible for inclusion had an available Ebola virus RT-PCR result, available key data, were eligible for vaccination during the outbreak, and had symptom onset aligning with the period in which a ring-vaccination protocol was in use. After imputing missing data, each individual confirmed by RT-PCR to be Ebola virus disease-positive (defined as a case) was matched to one individual negative for Ebola virus disease (control) by sex, age, health zone, and month of symptom onset. Effectiveness was estimated from the odds ratio of being vaccinated (≥10 days before symptom onset) versus being unvaccinated among cases and controls, after adjusting for the matching factors. The imputation, matching and effectiveness estimation, was repeated 500 times.
Findings |
1273 (4·8%) of 26 438 eligible individuals were positive for Ebola virus disease (cases) and 25 165 (95·2%) were negative (controls). 40 (3·1%) cases and 1271 (5·1%) controls were reported as being vaccinated at least 10 days before symptom onset. After selecting individuals who reported exposure to an individual with Ebola virus disease within the 21 days before symptom onset and matching, the analysis datasets comprised a median of 309 cases and 309 controls. 10 days or more after vaccination, the effectiveness of rVSV-ZEBOV against Ebola virus disease was estimated to be 84% (95% credible interval 70–92).
Interpretation |
This analysis is the first to provide estimates of the real-world effectiveness of the rVSV-ZEBOV vaccine against Ebola virus disease, amid the widespread use of the vaccine during a large Ebola virus disease outbreak. Our findings confirm that rVSV-ZEBOV is highly protective against Ebola virus disease and support its use during outbreaks, even in challenging contexts such as in the eastern Democratic Republic of the Congo.
Funding |
Médecins Sans Frontières.
Translation |
For the French translation of the abstract see Supplementary Materials section.
Le texte complet de cet article est disponible en PDF.Plan
Vol 24 - N° 12
P. 1357-1365 - décembre 2024 Retour au numéro
Article précédent
- Investigating the effect of enhanced cleaning and disinfection of shared medical equipment on health-care-associated infections in Australia (CLEEN): a stepped-wedge, cluster randomised, controlled trial
- Katrina Browne, Nicole M White, Philip L Russo, Allen C Cheng, Andrew J Stewardson, Georgia Matterson, Peta E Tehan, Kirsty Graham, Maham Amin, Maria Northcote, Martin Kiernan, Jennie King, David Brain, Brett G Mitchell
- Safety and efficacy of PfSPZ Vaccine against malaria in healthy adults and women anticipating pregnancy in Mali: two randomised, double-blind, placebo-controlled, phase 1 and 2 trials
- Halimatou Diawara, Sara A Healy, Agnes Mwakingwe-Omari, Djibrilla Issiaka, Aye Diallo, Seydou Traore, Ibrahim H Soumbounou, Santara Gaoussou, Irfan Zaidi, Almahamoudou Mahamar, Oumar Attaher, Michal Fried, Blair J Wylie, Rathy Mohan, Viyada Doan, Justin Y A Doritchamou, Amagana Dolo, Robert D Morrison, Jing Wang, Zonghui Hu, Kelly M Rausch, Amatigue Zeguime, Tooba Murshedkar, Natasha KC, B Kim Lee Sim, Peter F Billingsley, Thomas L Richie, Stephen L Hoffman, Alassane Dicko, Patrick E Duffy, PfSPZ Vaccine Study Team, Moussa Traore, Mamoudou Samassekou, Oumar Mohamed Dicko, Oulematou N’Diaye, Youssoufa Sidibe, Sidi Mohamed Niambele, Kalifa Diarra, Kadidia Baba Cisse, Ibrahim Diarra, Amadou Niangaly, Balla Diarra, Karim Bengaly, M’Bouye Doucoure, Adama Dembele, Idrissa Samake, Bakary Soumana Diarra, Jacquelyn Lane, J. Patrick Gorres, Omely Marte-Salcedo, Daniel Tran, Jillian Neal, Aissatou Bah, Mahesh Gupta, Yonas Abebe, Eric R. James, Anita Manoj
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?