FRANCE 24: The new vaccine rVSV-ZEBOV was used successfully on a few thousands people in Guinea during the last Ebola outbreak in West Africa, but it is still in its experimental stage. Are there any ethical problems linked to the use of this vaccine this time?
Hugues Robert: The vaccine is only offered to people who are very likely to catch the disease. Patients can choose whether or not to accept it, and this is done through a written agreement. Typically, a family that has had a case of Ebola and who has cared for that person, who has fed and cleaned him or her and washed his sheets and clothes, has a higher risk of getting sick.
People who are given the vaccine are very well informed beforehand on the possible side effects. We are aware of some of them, especially arthritis and skin lesions (papules), which aren’t difficult to treat but are uncomfortable for the patient. However, the fact that we are still at the experimental stage means that there is a whole procedure in place for patients and for monitoring them afterwards. This procedure forces us, when we are working in very remote places, to return to see our patients every 28 days and, if a woman is pregnant, until the end of her pregnancy.
NOTE! IF WHO HAD DECLARED EBOLA AN INTERNATIONAL EMERGENCY ON MAY 18TH, IT WOULD HAVE OPENED THE DOOR TO IMMEDIATE MASS VACCINATIONS IN THE CONGO WITHOUT ADEQUATE MONITORING. THE WORLD ESCAPED A POTENTIALLY VERY DAST AND CATASTROPHIC EXPLOSION OF EBOLA CASES AROUND THE CONGO, AFRICA AND THE WORLD (AIR TRAVEL) AND CALLS FOR MASS, FORCED VACCINATIONS.
THE FACT IT COULD ONLY BE GIVEN AS AN EXPERIMENTAL VACCINE OBLIGED MSF AND THE REST TO ALLOW FOR STRICT SUPERVISION, LIMITING ANY CAPACITY TO EXPLOIT THE SITUATION TO SPREAD EBOLA VIA A JAB.
All of that takes much more time than it does when a vaccine has been approved, and it limits the number of people we can innoculate. It’s much more complicated to vaccinate more than 40 to 50 people a day if we want to make sure that all the right procedures are followed. We’re not far off from rVSV-ZEBOV being approved, but we can’t yet carry out a mass vaccination as it has been done for measles when several hundred people can be reached daily.
Why did you choose the ring vaccination method rather than a mass vaccination campaign?
A global mass campaign isn’t possible, firstly because of the number of vaccines available but also because of the way we can administer it. Because rVSV-ZEBOV hasn’t yet been approved, we can’t go as fast as we would do with a mass vaccination. This ‘ring’ method means we can target the areas and people who are most at risk. Eventually, if the situation is properly monitored, you can put out the flames very quickly. From that point of view, there is no point in flooding the population with vaccines.
This article originally appeared in French.
Date created : 2018-06-04