Breastfeeding women to get Ebola vaccine in WHO-Ebola U-turn

By Komakech Jimmy

Pregnant and breastfeeding women will be given the experimental Ebola vaccine, making a U-turn in World Health Organization’s (WHO) policy.

A meeting of the WHO’s expert vaccine advisory group reversed a previous decision to deny pregnant women the vaccine because there was not enough evidence of its safety.

Reluctance to offer the vaccine to pregnant and lactating women is based on the fact that “it is a live-virus vaccine”.

The virus it contains is not Ebola; it is a livestock virus called vesicular stomatitis virus that can infect, but does not sicken people.

A key protein from the Ebola virus has been fused to the VSV virus, which then prompts the immune system to develop a protective response to Ebola – health experts say.

This approach has led to anger among some, that women are being put at risk during the current Ebola outbreak in the Democratic Republic of Congo (DRC).

Studies show that 80-90 percent of pregnant women who contracted Ebola died.

Very few babies of Ebola-affected mothers have survived.

But the latest recommendations from WHO’s Strategic Advisory Group of Experts (SAGE) on immunization said that “because of the severity of the outbreak, pregnant women should be included in the campaign, as long as they and their babies are monitored”.

In a statement, SAGE said: “As recommended by the ethics committee, every effort must be made to collect data on the safety of the vaccine in these populations, including a documentation of the pregnancy outcomes.”

“SAGE advises that the use of VSV-ZEBOV-GP vaccine in pregnant women currently remains limited to the Ebola virus disease outbreak affected areas in DRC and should be continuously evaluated based on the emerging data on the safety and efficacy of the vaccine in this target population. This careful review of the emerging safety data is needed to inform vaccine recommendations for future outbreaks.”

WHO and other international agencies are struggling to control the outbreak of Ebola in DRC, where there have been 840 cases of the disease since last August – 2018, including 537 deaths.

There have been fewer cases of the virus in the last week, although WHO says that the outbreak is continuing with “moderate intensity”.

In another Ebola vaccine development, the report from the SAGE committee revealed that the group has recommended the testing of other experimental Ebola vaccines during this outbreak.

Three in particular were considered: One made by Johnson and Johnson and a Russian and a Chinese vaccine. The latter two have been licensed in those countries, but none of the three has been proven to be protective in a Phase 3 clinical trial.

The committee recommended that these vaccines could be used in clinical trials that enrolls health care and front line workers in areas around the outbreak zone — areas where Ebola is not transmitting but might, at some point.

Several years ago the SAGE agreed that during dangerous yellow fever outbreaks, pregnant women should be offered the chance to be vaccinated.

The yellow fever vaccine is also a live-virus vaccine and it is known to cause serious side effects in a small portion of people who receive it.

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