ErveboIn 2014, an outbreak of Zaire ebolavirus in the West African countries of Guinea, Liberia and Sierra Leone resulted in more than 28,000 cases and 11,000 deaths. Ebola virus disease (EVD) outbreaks were documented since the 1970s. However, the widespread nature of the 2014 epidemic caused global fear. Many countries responded by imposing travel restrictions against West African nations. Fortunately, the U.S. Food and Drug Administration approved the first Ebola vaccine (Ervebo) in December 2019.

10 Facts About the Ervebo Ebola Vaccine

  1. Trials began in 2018. The World Health Organization (WHO) and the Democratic Republic of the Congo (DRC) began to trial Ervebo in 2018 as an investigational vaccine under an expanded access program. The DRC experienced the world’s second-largest Ebola outbreak. The vaccine use aimed to prioritize people most at risk such as healthcare workers.
  2. Roughly 290,000 people received vaccinations. In response to the Ebola outbreak in the DRC, more than 290,000 people have received the Ervebo vaccination under compassionate use protocols. Compassionate use allows for the limited allocation of an unlicensed vaccination due to a dangerous public crisis.
  3. Ervebo is 100% effective. A study in Guinea during the 2014-2016 outbreak indicates that Ervebo was 100% effective for individuals 18 and older. In a comparison of cases, Ervebo was 100% effective in preventing cases of Ebola with symptom onset more than 10 days after inoculation. The comparison involved 2,108 participants in an “immediate” vaccination group and 1,429 participants in a “delayed” vaccination group.
  4. Trials outside of West Africa. In addition to West Africa, trials of the Ebola vaccine occurred in Canada, Spain and the United States. Because Ebola is not endemic to Europe or North America, researchers wanted to measure the antibody response among individuals with no history of previous exposure. The antibody responses among participants in Canada, Spain and the U.S. were close to that of individuals in Liberia and Sierra Leone.
  5. Ervebo is safe for all participants. Roughly 15,000 individuals in Africa, Europe and North America were part of vaccine trials. The trials determined that the vaccine is safe and effective for all individuals. Individuals reported only minor side effects.
  6. Ervebo is a single-dose vaccine. Ervebo is a single-dose injection that does not require boosters. This allows for faster distribution and protection against EVD. The vaccine is a “live, attenuated vaccine that is genetically engineered to contain protein from the Zaire ebolavirus.”
  7. The vaccine received priority review. Due to the importance of developing an Ebola vaccine as a public health measure, Ervebo received a priority review and a tropical disease priority review voucher by the FDA under a program supporting the development of new drugs for the prevention and treatment of tropical diseases. Ervebo also received a breakthrough therapy designation to assist with the development of the vaccine. The FDA worked closely with the company, Merck & Co., Inc., and completed the evaluation in less than six months.
  8. The vaccine will be available to those most in need. Due to limited supplies of Ebola vaccines, Ervebo will be available as part of a ring vaccination strategy during future outbreaks. This strategy means that those most at risk will receive first priority. Vaccination efforts will start with people like healthcare workers and extend outward to other members of the community.
  9. A global stockpile will be available in January 2021. Beginning in January 2021, a global stockpile of the vaccine will be available through the International Coordinating Group (ICG) on Vaccine Provision. The ICG also manages stockpiles of cholera, meningitis and yellow fever vaccines and will be responsible for decision-making on allocation.
  10. Four African countries have licensed the vaccine. In February 2020, the Democratic Republic of the Congo (DRC), Burundi, Ghana and Zambia licensed the Ervebo vaccine. The license means the manufacturer can stockpile and widely distribute the vaccine within these countries. No further research or clinical trials are necessary with a license.

The Future

One cannot undo the damage of past outbreaks but the Ervebo Ebola vaccine may be a valuable tool for future Ebola prevention efforts. As the vaccine becomes widely available in future years, the World Health Organization hopes the population of West Africa will achieve herd immunity against the disease, eradicating the spread of EVD. The technology used in the development of the Ebola vaccine will also aid in the quick development of vaccines for future global outbreaks. As the world continues to struggle against COVID-19, the success of Ervebo provides a blueprint for the prevention and mitigation of future epidemics.

Eliza Browning
Photo: Flickr

Digital Healthcare in Japan
Japan’s population is 126,406,369 as of September 2020, yet 20% of the country’s populace is above the age of 65. This is the highest rate of the elderly in relation to overall population density across the globe. By 2030, the aging populace might increase to one in three over the age of 65. With such an exacerbated aging population, digital healthcare in Japan has taken the reigns of health moving forward.

What is Digital Health?

Digital health covers an array of evolving technologies to meet the needs of the healthcare systems of the 21st century. This includes telehealth, wearable devices, mobile health, telemedicine, personalized medicine and health information technology. This empowers patients to be more connected to their health needs and healthcare team. Digital healthcare assists in disease prevention, early diagnosis and management of lifelong chronic illnesses.

Also, mobile applications have been on the rise. They help doctors to make clinical decisions without face-to-face contact. These tools have vastly optimized treatment and delivery, and it further provides a holistic view of data based on a patient’s record. These technologies aim to reduce costs, increase quality, improve access, reduce inefficiencies and make medicine personalized. In conjunction with smart devices and applications, it is changing the way health professionals communicate with patients.

The Digital Hospital

Additionally, as Japan’s population continues to age, a new approach to how hospitals operate is paramount. A culture to implement digital transformation is essential in helping management push for digital healthcare on every organizational level. Ensuring communication between various technologies and devices is critical in moving hospitals forward. With technology constantly evolving, hospitals will need to plan for aging software and hardware. Furthermore, a larger focus on data will develop a solid foundation as hospitals begin to transform into the digital landscape. As the digital age continues to revolutionize hospitals, the staff becomes a dire investment as they formulate digital strategies. Also, cybersecurity will need to proliferate to secure hospital data from potential breaches.

Japan’s Digital Healthcare Revolution

Japan’s population is aging with around 21% of the population being 65 and older, which has created a challenge for the preexisting healthcare system. The government of Japan has focused on a strategy centered around digital healthcare to help this problem. The country sees it as an opportunity for growth.

Telemedicine and mobile applications are paving the way for digital health in Japan. Patients can connect with physicians via any mobile device to access medical data and hold video chats with doctors. This removes the travel and wait times patients would have had otherwise. It would also prove to be most beneficial for patients living in remote or rural areas.

Furthermore, even virtual reality has helped healthcare workers understand how various diseases affect patients. Silver Wood Corp, a Tokyo based firm, developed a simulation to mimic the effects of dementia. It is aided in providing a deeper understanding of such a complex illness while offering help with treatment.

Overall, Japan’s population is getting older in relation to the rest of its population. However, with these new technological developments and strategies, the country is creating a more stable and accessible healthcare model. Moving forward, technologies like VR, smart devices and wearable devices will greatly improve the standard of care Japan has come to expect. With so many innovations on the rise, Japan’s digital healthcare revolution is prepared to meet the demands of an aging society.

As the new digital age of medicine takes the forefront of patient care in Japan, it will also help set a precedent for implementation across the globe. Telehealth practices can help underserved areas gain access to medical professionals without the need to spend costly time or money for an in-person visit. Nations with spread-out populations or a lack of physical infrastructure may want to look into expanding internet access and incentivizing telehealth practices to help underserved communities utilize the medical resources they desperately need.

Michael Santiago
Photo: Wikimedia Commons

New Ebola and Malaria Vaccines
In December 2019, the Gavi Board, an organization that improves the accessibility of immunizations to vulnerable children, approved a new program that will allocate new Ebola vaccines. A new funding initiative will invest about $178 million by 2025 for a new program to develop the vaccines. The decision is monumental in leading global health emergency stockpiles, which will grow to 500,000 doses.

Ebola’s Effect on Poverty

A study in December 2014 in Liberia indicated that the infectious disease hits poorer neighborhoods most. People in poverty are 3.5 times more likely to contract the disease than those in wealthier areas. Due to the dense population and lack of sanitation and health care facilities, the people in these communities are more susceptible to the virus. Ebola first appeared on an epidemic level in West Africa in 2014. While it existed prior to that, those cases were more contained. Crowded urban areas resulted in higher transference, further developing the outbreak.

Malaria Vaccines

In addition to the Ebola vaccine, Gavi approved continued steps in curating an implementation program for new malaria vaccines. The routine distribution of these vaccines will reduce child death significantly. Malaria is the primary cause of death of children under 5-years-old, with a reported 228 million cases and 405,000 deaths in 2018 alone. Malaria is also one of the top four causes of poverty, according to the United Nations. Its lack of affordable measures has strained many African economies, costing an estimated $30 billion a year. Many people cannot afford efficient medication and 20 percent often die due to poorly distributed drugs.

Countries affected by poverty and low income will have access to these vaccination campaigns free of charge, which will help boost economies. Countries such as the Democratic Republic of the Congo (DRC) have continually experienced rash Ebola outbreaks, with the latest one being in August 2018. Since then, the DRC has grappled with over 2,200 lives lost and 3,421 more reported cases in January 2020. In July 2019, the World Health Organization declared the Ebola outbreak a public health emergency that called for international concern.

The US Fights Against Ebola

The U.S. Food and Drug Administration (FDA) will also participate in close efforts to fight the Ebola outbreak in the DRC. The FDA granted programs in order to advance the development of new drugs that will lead to the prevention of tropical diseases. People primarily contract Ebola through direct contact with bodily fluids, blood and infected wild animals or people. Limiting these factors is difficult, but with proper medication and programs, along with the investments in sanitation and health care facilities, outbreaks will significantly reduce. These types of decisions are paramount in shifting the United States’ focus to a more global standpoint in regards to large-scale poverty.

The development of Ebola and malaria vaccination pilots is essential to the sustainability of areas affected by extreme poverty. Preventable measures will reduce the risk of contracting infectious diseases among these low-income communities. These comprehensive overviews will scale back the rate of Ebola outbreaks in African regions, which will also cut back on excessive government spending. Vaccination programs will help prevent 24 million people from facing extreme poverty by 2030. People could prevent a quarter of deaths that the outbreaks caused through simple vaccination, which makes these programs all the more noteworthy. The Gavi Board and the FDA’s efforts in launching new malaria and Ebola vaccines will contribute to the positive impact.

Brittany Adames
Photo: Wikimedia Commons

Fragile Vaccines

Researchers at McMaster University in Ontario, Canada, have developed a possible breakthrough with regards to the storage of certain fragile vaccines. They have found a way to protect these vaccines from direct heat, negating the need for them to be stored in a cool environment. The implications of this innovation are massive. If organizations like Health Canada approve it, the reach of vaccinations to rural areas will increase, and with that, disease and sickness should decrease.

Coating on Vaccines

The researchers found that placing a gel-like coating over the vaccines was the best way to protect them from the heat. To make this coating, researchers mixed two sugars, trehalose and pullulan, with the vaccine and let it dry. As the sugars dried, the researchers coated the vaccine, making it resistant to heat and rendering the cold chain (the process of storing vaccines at temperatures ranging from 2 C to 8 C) unnecessary. Heat resistance is important because many people living in more rural areas of the world do not have access to refrigeration. Now, individuals living in impoverished areas will have access to a number of vital vaccines, helping protect them from diseases such as Ebola and influenza.

The technology’s development was the result of countless years of testing and hard work. But it is clear that the end product will be more than worth the time spent. When asked about the significance of the technology, Vincent Leung, an Assistant Professor of Chemical Engineering at McMaster and one of the masterminds of the testing, said that it is “very exciting that something we worked on in the lab has the possibility of saving people’s lives one day.” Leung has reason to be proud; the technology is filling a clear need and will undoubtedly have a massive impact upon its implementation.

What Happens Next

Health Canada and the U.S. Food and Drug Administration must still provide approval for the new technology. These organizations will analyze the effectiveness, practicality and safety of the technology. These organizations are likely to approve it because both have already accepted trehalose and pullulan.

The researchers have received funding from many organizations around the world, including the Bill and Melinda Gates Foundation. They are now working with commercial partners in an effort to get the technology to market upon approval. Once accepted, it will likely see heavy usage in more rural parts of the world, such as in many regions of Africa. In many of these areas, individuals do not receive vaccinations for preventable diseases. In fact, more than 7.6 million children in Africa are not vaccinated each year.

This new innovation to transport fragile vaccines has immense potential to shape the future in a positive way. Vaccines will now become cheaper and more efficient to transport around the world. In addition, as more individuals obtain vaccinations, rates of disease and poverty should decrease and life expectancy should increase. While there are still many steps for this new technology to take before implementation, the promise of the technology provides immense hope.

– Kiran Matthias
Photo: Flickr