Deployment of and compliance with vaccination regimens
For a vaccine to have a real impact on an outbreak, high levels of vaccination coverage are essential. In addition, for lasting protection, two doses of the vaccine may be needed. However, the stigma surrounding Ebola, coupled with a suspicion of vaccines in general, could deter many people from getting vaccinated. Strong communication campaigns are therefore needed to address these challenges.
The EBODAC project is developing a communication strategy and tools to promote the acceptance and uptake of new Ebola vaccines. One of the project’s most important products will be a platform, based on mobile technology, dedicated to Ebola vaccines. As well as providing local communities with information on Ebola and vaccines, the platform will send reminders to people receiving the ‘prime boost’ vaccine to return to get their second ‘booster’ dose and facilitate the tracking of vaccination coverage. EBODAC is also setting up local training programmes to make sure the communication strategy, and its tools, will be ready for deployment in the local setting.
A part of the Ebola+ Programme
The IMI Ebola+ programme was launched in response to the Ebola virus disease (EVD) outbreak that started in western Africa in 2014. The comprehensive programme contributes to efforts to tackle a wide range of challenges in Ebola research, including vaccines development, clinical trials, and transport, as well as diagnostics. The programme complements work being carried out with the support of other funding bodies. In addition to Ebola, the programme will also address related diseases, such as Marburg.
About Ebola and related diseases
Ebola virus disease (EVD), previously known as Ebola haemorrhagic fever, is a rare and deadly disease caused by infection with one of the Ebola virus strains. The virus spreads in the human population through direct human-to-human contact with the bodily fluids of infected patients who are showing symptoms. It has an incubation period of 2-21 days, and it usually begins with flu-like symptoms, but rapidly progresses to multiple organ failure and blood-clotting abnormalities which manifest as internal and external haemorrhages (bleeding). It is fatal in between 25% and 90% of cases. There is currently no licensed treatment against EVD, and the development of treatments and preventive measures such as vaccines is hampered by challenges including manufacturing-related hurdles, the stability of vaccines during transport and storage, vaccine deployment, and the time taken to diagnose cases of EVD.
Ebola is a member of the filovirus family of viruses, which also includes Marburg virus. Like Ebola, Marburg causes cause severe, often fatal haemorrhagic fever in humans and other primates (monkeys, gorillas and chimpanzees), and like Ebola, it is transmitted directly from one person to another. (In contrast, other viruses that cause haemorrhagic fevers are spread via intermediate hosts - for example, dengue fever is transmitted by mosquitoes.) There is no specific treatment or vaccine against Marburg haemorrhagic fever.
The 2014-15 Ebola epidemic was unprecedented in its scale and geographical distribution. By the middle of 2015, World Health Organization (WHO) statistics recorded over 27 000 cases and 11 000 deaths from the disease, most of them in Guinea, Liberia, and Sierra Leone. The epidemic highlighted the need for research into better vaccines, diagnostics and treatments to stop future epidemics in their tracks.
Achievements & News
When IMI’s EBODAC project started in late 2014, Ebola had already killed over 8 000 people in just a few short months, most of them in the western African nations of Liberia, Guinea and Sierra Leone. With the outbreak continuing to devastate lives across the region, fear and anxiety were rife, and rumours spread rapidly through local communities.### It was against this backdrop that IMI’s EBODAC project set out to develop a community engagement strategy to enable a clinical trial of a promising new Ebola vaccine candidate. Thanks to the many innovative methods employed, including radio and drama shows, the project is now celebrating its first big success: all of the adults in the trial have been successfully vaccinated. ‘The success of the project wouldn’t have been possible without the public-private partnership nature and the support of IMI,’ said Heidi Larson of the London School of Hygiene & Tropical Medicine, the EBODAC project coordinator. ‘Given the sensitive nature of our trust-building, community engagement, communication and rumour management, it was particularly important that the funding for that dimension of the trial was coming from the public sector rather than the industry. At the same time, the private sector partnership was crucial to the collaboration and the success.’
- Read the full success story
IMI’s EBODAC project is developing strategies and tools to promote the acceptance and uptake of new Ebola vaccines in local communities in Africa. In this context, the EBODAC consortium is organizing a symposium entitled ‘Community engagement, communications and enabling technology in Ebola clinical trials’. ###The symposium will take place on 20-21 February in Dakar, Senegal. It will gather experts from around the world to discuss communications, community engagement strategies, and technologies used in clinical trials during the Ebola outbreak. Moreover, the event will offer an opportunity to exchange lessons learned, develop recommendations for future trials occurring in outbreak settings and gather insights to develop an open source online training tool focusing on community engagement. Prominent speakers will include Professor Peter Piot, Director of the London School of Hygiene & Tropical Medicine and co-discoverer of the Ebola virus, and Dr Awa Marie Coll-Seck, Senegal’s Minister of Health. The event is by invitation only. If you are interested in attending please contact Valérie Heywood: firstname.lastname@example.org.
A clinical trial of an investigational Ebola vaccine regimen is now underway in Kambia, Sierra Leone thanks to the IMI projects EBOVAC1, EBODAC and EBOMAN. ###
Even in the short term, the benefits to the local community of the ‘EBOVAC-Salone’ trial are immense; new facilities had to be built to run the study, including the first emergency room at the local district hospital, and a vaccine storage facility. In addition, the project provides both jobs and training for local healthcare workers, who will also gain valuable experience by working on the trial. In the longer term, the community may also benefit if the vaccine regimen is approved.
Sierra Leone was at the epicentre of the Ebola outbreak, with 14 000 cases and 4 000 deaths, including many healthcare workers. The vaccine regimen under investigation is a ‘prime-boost’ regimen, in which two doses are given several weeks apart. The first dose ‘primes’ the immune system, while the second ‘boost’ reinforces its effects with the goal of potentially strengthening and optimising the duration of the immunity. The study is notable in that it will evaluate the vaccine regimen’s safety and immune response within the general population of Sierra Leone, including vulnerable groups such as adolescents and children. The vaccine regimen is also in trials in other parts of Africa, Europe and the US.
The EBOVAC-Salone trial is working closely with the IMI project EBODAC, which aims to ensure the prime-boost vaccine regimen is well accepted and successfully deployed. It is doing this by informing local engagement strategies, designing graphical communication aids, deploying technological solutions to increase compliance and uniquely identifying trial participants.
ParticipantsShow participants on map
- Janssen Pharmaceutica Nv, Beerse, Belgium
Universities, research organisations, public bodies, non-profit groups
- Grameen Foundation Usa, Washington, District of Columbia, United States
- London School Of Hygiene And Tropical Medicine Royal Charter, London, United Kingdom
Small and medium-sized enterprises (SMEs) and mid-sized companies (<€500 m turnover)
- World Vision Of Ireland Lbg, Rathmines Park, Ireland
- World Vision International, Monrovia Ca, United States
- World Vision Sierra Leone, Freetown, Sierra Leone
|Name||IHI funding in €|
|Grameen Foundation Usa||3 454 516|
|London School Of Hygiene And Tropical Medicine Royal Charter||3 380 903|
|World Vision Of Ireland Lbg||5 318 468|
|Name||Funding in €|
|World Vision International||2 000 000|
|World Vision Sierra Leone||6 174 970|
|Total Cost||20 328 857|