Impact of prophylactic vaccination strategies on Ebola virus transmission: A modeling analysis

PLoS One. 2020 Apr 27;15(4):e0230406. doi: 10.1371/journal.pone.0230406. eCollection 2020.

Abstract

Ebola epidemics constitute serious public health emergencies. Multiple vaccines are under development to prevent these epidemics and avoid the associated morbidity and mortality. Assessing the potential impact of these vaccines on morbidity and mortality of Ebola is essential for devising prevention strategies. A mean-field compartmental stochastic model was developed for this purpose and validated by simulating the 2014 Sierra Leone epidemic. We assessed the impacts of prophylactic vaccination of healthcare workers (HCW) both alone and in combination with the vaccination of the general population (entire susceptible population other than HCW). The model simulated 8,706 (95% confidence intervals [CI]: 478-21,942) cases and 3,575 (95%CI: 179-9,031) deaths in Sierra Leone, in line with WHO-reported statistics for the 2014 epidemic (8,704 cases and 3,587 deaths). Relative to this base case, the model then estimated that prophylactic vaccination of only 10% of HCW will avert 12% (95% CI: 6%-14%) of overall cases and deaths, while vaccination of 30% of HCW will avert 34% of overall cases (95% CI: 30%-64%) and deaths (95% CI: 30%-65%). Prophylactic vaccination of 1% and 5% of the general population in addition to vaccinating 30% of HCW was estimated to result in reduction in cases by 44% (95% CI: 39%-61%) and 72% (95% CI: 68%-84%) respectively, and deaths by 45% (95% CI: 40%-61%) and 74% (95% CI: 70%-85%) respectively. Prophylactic vaccination of even small proportions of HCW is estimated to significantly reduce incidence of Ebola and associated mortality. The effect is greatly enhanced by the additional vaccination even of small percentages of the general population. These findings could be used to inform the planning of prevention strategies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Computer Simulation
  • Disease Outbreaks / prevention & control*
  • Ebolavirus
  • Health Personnel
  • Hemorrhagic Fever, Ebola* / epidemiology
  • Hemorrhagic Fever, Ebola* / prevention & control
  • Hemorrhagic Fever, Ebola* / transmission
  • Humans
  • Incidence
  • Mortality
  • Pre-Exposure Prophylaxis*
  • Sierra Leone / epidemiology
  • Vaccination / statistics & numerical data*

Grants and funding

The study was commissioned and funded by Janssen Vaccines & Prevention of Johnson and Johnson. The funders had no role in model design, data collection and analysis, decision to publish, or preparation of the manuscript. At the time of writing this manuscript, CS was employed by Janssen Vaccines & Prevention, Raritan, NJ, USA, and VOM, KL and BC were employed by Janssen Vaccines & Prevention B.V., Leiden, The Netherlands and RP, AK, VM and HB were employed by SmartAnalyst Inc, New York, NY, USA or its subsidiaries. While Janssen Vaccines & Prevention and Janssen Vaccines & Prevention B.V. provided support in the form of salaries to authors CS, VOM, KL and BC, they did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the author contributions section. Additionally, assistance in the preparation of this manuscript was provided by Asclepius Medical Communications LLC, Ridgewood, NJ.