Subject(s)
Ebola Vaccines/immunology , Ebolavirus/immunology , Hemorrhagic Fever, Ebola/prevention & control , Mass Vaccination , Africa/epidemiology , Clinical Trials as Topic , Democratic Republic of the Congo/epidemiology , Disease Outbreaks/prevention & control , Ebola Vaccines/administration & dosage , Ebolavirus/pathogenicity , Hemorrhagic Fever, Ebola/epidemiology , Hemorrhagic Fever, Ebola/immunology , HumansSubject(s)
COVID-19/epidemiology , Hemorrhagic Fever, Ebola/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , Democratic Republic of the Congo/epidemiology , Disease Outbreaks , Ebola Vaccines/administration & dosage , Ebolavirus/isolation & purification , Guinea/epidemiology , Hemorrhagic Fever, Ebola/prevention & control , Humans , SARS-CoV-2/isolation & purification , Vaccination/statistics & numerical dataABSTRACT
The conduct of clinical trials during the West Africa Ebola outbreak in 2014 highlighted many ethical challenges. How these challenges were addressed, what clinical studies were conducted during that outbreak, and the lessons learned for dealing with future outbreaks were the subject of a National Academy of Medicine committee report titled Integrating Clinical Research into Epidemic Response: The Ebola Experience. This report suggested improvements for research during subsequent emerging or re-emerging outbreaks and is summarized in this review. We also discuss the current Ebola outbreak in the Democratic Republic of the Congo and highlight how the dialogue has changed and how successful clinical trials have been implemented. We conclude with a description of productive efforts to include pregnant women and children in therapeutic and vaccine trials during outbreaks that are currently ongoing.
Subject(s)
Biomedical Research/ethics , Clinical Trials as Topic/ethics , Disease Outbreaks , Ebolavirus/pathogenicity , Hemorrhagic Fever, Ebola/epidemiology , Patient Selection/ethics , Adult , Africa, Western/epidemiology , Antiviral Agents/therapeutic use , Biomedical Research/organization & administration , Child , Clinical Trials as Topic/organization & administration , Ebola Vaccines/administration & dosage , Female , Hemorrhagic Fever, Ebola/immunology , Hemorrhagic Fever, Ebola/mortality , Hemorrhagic Fever, Ebola/prevention & control , Humans , International Cooperation , Male , Pregnancy , Survival AnalysisSubject(s)
Coronavirus Infections/epidemiology , Hemorrhagic Fever, Ebola/epidemiology , Hemorrhagic Fever, Ebola/prevention & control , Hemorrhagic Fever, Ebola/transmission , Pneumonia, Viral/epidemiology , Betacoronavirus , COVID-19 , Ebola Vaccines/administration & dosage , Epidemiological Monitoring , Health Facilities , Humans , Pandemics , SARS-CoV-2 , VaccinationABSTRACT
Vaccine solutions rarely reach the public until after an outbreak abates; an Ebola vaccine was approved 5 years after peak outbreak and SARS, MERS, and Zika vaccines are still in clinical development. Despite massive leaps forward in rapid science, other regulatory bottlenecks are hamstringing the global effort for pandemic vaccines.