Over the last four weeks, the Ebola outbreak in the Eastern Provinces of the Democratic Republic of Congo (DRC) has deteriorated with a large increase in the number of cases1. A major factor in this rise is an increase in critical security incidents that have dramatically affected the ability to identify, follow up and vaccinate contacts successfully. This context challenges the implementation of ring vaccination based on the identification of contacts and contacts of contacts, as recommended by SAGE in April 2017 and confirmed by SAGE during its April 2019 meeting. Further, a potential vaccine shortage may manifest in case the outbreak expands further and/or is prolonged.

SAGE deliberated on the following recommendations on implementation of novel strategies and adjusted dose regimes:

  1. Implementation of innovative operational strategies
  2. Revised vaccination strategy to adjust the target population for ring vaccination to include a second and third barrier of immunized individuals around each incident case.
  3. Alternative dosing for the rVSV-ZEBOV-GP vaccine
  4. Proposal to further adjust the protocol to incorporate alternative individual informed consent forms
  5. Implementation of a mass communication campaign