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.

Autor:	Meakin S; Epicentre, Paris, France. Electronic address: sophie.meakin@epicentre.msf.org., Nsio J; General Direction of Disease Control, Ministry of Public Health, Hygiene, and Prevention, Kinshasa, Democratic Republic of the Congo., Camacho A; Epicentre, Paris, France., Kitenge R; National Program of Care and Follow-up of Survivors, Ministry of Public Health, Hygiene, and Prevention, Kinshasa, Democratic Republic of the Congo., Coulborn RM; Epicentre, Paris, France., Gignoux E; Epicentre, Paris, France., Johnson J; Médecins Sans Frontières, Paris, France., Sterk E; Médecins Sans Frontières, Geneva, Switzerland., Musenga EM; Expanded Programme on Immunization, Ministry of Public Health, Hygiene, and Prevention, Kinshasa, Democratic Republic of the Congo., Mustafa SHB; Expanded Programme on Immunization, Ministry of Public Health, Hygiene, and Prevention, Goma, Democratic Republic of the Congo; Department of Public Health, Faculty of Medicine, University of Goma, Goma, Democratic Republic of the Congo; Department of Epidemiology, Faculty of Health and Community Development, Université de Pays de Grand Lacs, Goma, Democratic Republic of the Congo., Finger F; Epicentre, Paris, France., Ahuka-Mundeke S; Department of Virology, Institut National de la Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Department of Medical Biology, Cliniques Universitaires de Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
Jazyk:	angličtina
Zdroj:	The Lancet. Infectious diseases [Lancet Infect Dis] 2024 Dec; Vol. 24 (12), pp. 1357-1365. Date of Electronic Publication: 2024 Aug 20.
DOI:	10.1016/S1473-3099(24)00419-5
Abstrakt:	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. Competing Interests: Declaration of interests We declare no competing interests. (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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