In 1976, near the Ebola River in what is now the Democratic Republic of Congo, the disease known as Ebola was first described. For years afterward, scientists fought a largely fruitless uphill battle toward development of an effective and sustainable vaccine for this disease. After sporadically plaguing parts of Africa for decades, a 2014 widespread outbreak of Ebola sent shockwaves through not only West Africa, but the entire world, finally demanding the attention and scientific research support that it had always so desperately needed. The clinical trials and approval process for the rVSV-ZEBOV vaccine, known as Ervebo, were a whirlwind, commonly regarded as a scientific and logistical miracle; however, the road leading to these advancements was littered with seemingly insurmountable obstacles.
A promising Ebola vaccine backbone was first seriously discussed in the early 1990s – so what took so long to get it developed and approved? It was only through the dogged determination of a few scientists and a laboratory mishap that the vaccine status arrived where it is today.
Barriers on this long road were many. The World Health Organization (WHO) turned down multiple vaccine proposals. Funding was scarce and scant due to lack of interest in working on Ebola prevention and eradication; the pharmaceutical industry brazenly questioned the purpose of pouring resources into research which would largely benefit only poor and rural African communities. Scientists frequently found themselves having to defend their research against persistent scrutiny. Health infrastructure in affected nations was weak. Other more visible widespread health scares such as the SARS virus garnered more attention and therefore more research funding. Urgency simply did not exist.
In 2009, a German scientist accidentally pricked her finger with a needle containing the Ebola virus, initiating a swift response which would drastically change the course of vaccine development. The unnamed scientist was almost immediately given the vaccine, which was not human grade and completely untested on humans. After several days of quarantine, she was found to be uninfected with Ebola and, more importantly, had not suffered any adverse side effects to the drug. Funding for the Ebola vaccine was eventually secured, but only to the tune of 2 million dollars, small by scientific research standards, from a company focused on biomedical terrorism. The lab in Winnipeg where research was being conducted finally found a development partner, but one who was not specifically interested in the work that was being done, but rather focused on growing its portfolio assets. The lab took the support wherever they could get it.
Then began the now-infamous Ebola outbreak, which likely began in Guinea in 2013 when patients with the disease were misdiagnosed and healthcare professionals contracted the illness from them; it was only then that Ebola was formally diagnosed. In 2014, it began to spread like wildfire in unparalleled ways into urban areas and eventually into other countries. It was declared a global health emergency by the WHO in August 2014.
It was during this time that scientists worked at a fever pitch to accelerate the development of the vaccine they so fervently believed in, often navigating murky ethical waters. Even after the drug was found to be clinically effective, the Food and Drug Administration in the United States expressed no interest in it. Still, researchers pressed on. Out of sheer necessity, complete clinical trials were eventually conducted, taking (from start to finish) fewer than 12 months, an unprecedented timeline in the field. Even after apparent vaccine success, there was substantial backlash doubting whether its efficacy was adequately proven.
Since another outbreak, this time in 2018 in the Democratic Republic of Congo, healthcare workers in the area have agreed to administer the vaccine via a “compassionate care” model. Since then, around 260,000 people have been successfully vaccinated.
At long last, the end of 2019 brought the news that scientists had been waiting for; In November, the European Commission approved Ervebo and in December, the U.S. Food and Drug Administration (FDA) did the same.