The Ebola vaccine: A Canadian success story
Originally published in The Hill Times, November 9, 2015
In December 2013, when the symptoms of the Ebola disease began to appear in the West African nation of Guinea, few could have predicted the magnitude and virulence of the epidemic that would follow and rapidly spread to the neighbouring countries of Liberia and Sierra Leone.
Discovered in the late 1970s, the Ebola virus had caused major outbreaks of hemorrhagic fever in Central Africa, but until two years ago, West Africa had not had any recorded Ebola deaths. As the disease progressed, however, it became evident that the West Africa Ebola outbreak would become a “public health emergency of international concern,” in the words of the World Health Organization, unless immediate action was taken.
The Ebola crisis presented the world with an urgent scientific challenge. Without effective vaccines or treatments and without coordination of efforts, it would be virtually impossible to halt the advance of the pandemic, much less reverse it.
For the Government of Canada, specifically the Canadian Institutes of Health Research (CIHR) and the Public Health Agency of Canada (PHAC), the global effort focused on the outbreak served as an occasion to bring Canadian research and innovation to the forefront of the crisis response.
At the time, the work of Canadian scientists in Ebola research was not yet visible. However, long before the outbreak occurred, PHAC’s National Microbiology Laboratory had been working on an experimental vaccine called the Vesicular Stomatitis Virus-Ebola Virus vaccine – known as VSV-EBOV. But the vaccine had never been tested on humans.
Canadian researchers quickly mobilized to launch a Phase I clinical trial of the vaccine – a test to determine whether it was safe for use on people. To conduct this clinical trial, CIHR joined forces with PHAC and the Canadian Immunization Research Network (CIRN) located in Halifax.
CIRN was chosen because of its world-class reputation for vaccine research, and because the facility features an emergency rapid response infrastructure. This facilitated the fast application, peer review, approval, and funding of the clinical trial.
The Phase I interim results demonstrated that there were no severe adverse reactions among people who had received the vaccine. Those findings became a key component of the international data set that was to lead to the selection of the VSV-EBOV vaccine for a Phase II-III trial to test the vaccine’s real world efficacy in preventing infection with Ebola.
As the Phase I trial launched, officials from CIHR, PHAC, the International Development Research Centre (IDRC), and the Department of Foreign Affairs, Trade, and Development (DFATD) engaged in discussions with the World Health Organization (WHO) to offer Canadian research support in setting up this Phase II-III Ebola vaccine trial in affected countries. The decision was made to carry out the study in Guinea, which possessed the necessary clinical infrastructure to carry out the trial. The decision was also made to carry out the trial in collaboration with Norway, which already had contacts on the ground, and to use a ring-vaccination approach, which focusses on contacts of infected patients.
After 4,394 doses of the vaccine had been administered to people in Guinea and the results carefully tracked, researchers concluded that the Canadian vaccine had clearly proved its effectiveness against the disease. In July 2015, that dramatic result would be publicized in The Lancet, one of the most prestigious medical journals in the world, which described VSV-EBOV as “highly efficacious and safe in preventing Ebola virus disease.”
For vaccine research in Canada and around the world, this is a major achievement. First, this success is a concrete example of how basic investigator-initiated research, a prerequisite for innovation, can provide the knowledge necessary to make important discoveries and solve pressing problems. Second, this accomplishment demonstrates that vaccine researchers, science and technology authorities, and government officials can come together effectively and quickly in a global crisis to deliver timely solutions.
In the case of Ebola, the ultimate goal is to reduce the number of cases to zero. In the pursuit of that goal, Canada’s efforts are continuing. For example, recently CIHR awarded funding to twelve research teams that will investigate ways to study the after effects of infection with Ebola, enhance prevention, and better manage health care during an outbreak, so as to better respond to future pandemics. This work is vitally important because of the elusive nature of the virus – it can disappear and then re-appear without warning.
The Canadian-made Ebola vaccine was a significant achievement. Our country moved as fast as possible, while maintaining the integrity of the scientific process, and coordinating our efforts with international partners. Most importantly, Canada’s vaccine has proven itself to be effective, and holds the promise of saving many lives in the future. As Canadians, we can all take pride in the major role Canadian science is playing in the global struggle against this deadly disease.
Alain Beaudet, MD, PhD
President, Canadian Institutes of Health Research
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