There have been mixed reactions from Liberians who learned last week that nearly 30,000 people are expected to be enrolled in the first large-scale trials of the Ebola experimental vaccine.
The vaccine uses a type of chimpanzee cold virus, and it is being carried out by the United States National Institutes of Health.
The vaccines, developed by GlaxoSmithKline, is targeting one-third of the 30,000 people, while others will get a routine vaccine against another disease, such as measles.
During the trial, investigators will look to see whether there are further cases of infection in the control group than among those who would be given the potential Ebola vaccine.
Sir Andrew Witty, the CEO of GlaxoSmithKline expressed high hopes for the potential vaccine that arrived in the country last Friday. However, while many Liberians interviewed said they planned to enroll in the trial, others told the Daily Observer they were not convinced of the vaccine’s effectiveness.
Participants who attended a one-day clinic at the Corporation Hall in New Kru Town were told that “no one is forced to take the vaccine.” But many wondered that if the vaccine has been developed to fight the Ebola virus disease, then “it must be made for people living in the badly hit communities to take the vaccine to protect themselves against Ebola.”
Others made references to, for example, the polio vaccine, that parents are encouraged to vaccinate their children against potential dangers in their children’s physical development.
What has compounded skeptics’ position is the late arrival of the vaccine at a time when there has been a reported rapid decline of Ebola cases in the country, according to the World Health Organization (WHO) and Liberian health officials, and therefore, “to find out whether the vaccine can work effectively against the Ebola virus disease,” as it is the case now raises questions.
GSK’s vaccine is the first of several being developed to enter trials in Liberia and neighbors Guinea and Sierra Leone.
Participants last Friday were told that trials of healthy volunteers in Europe, the US and unaffected African nations have shown it is safe and produces a response from the immune system. But what they could not confirm is the question of whether that response will protect vaccinated health workers and burial teams from infection or enable them to fight off the disease.
“Pregnant women and children cannot take the vaccine,” participants were told, “the rest of the people from 18 years and above are the targeted group.”
They were also told that any participant will receive thorough medical check-up to ensure that other diseases or infections are not lurking in a person’s system that may bring about other complications. There were many others who welcomed the trial. “I’ll take the vaccine,” said Mary Koffa, known popularly as Mary Broh, “if it is meant to protect me against the Ebola virus then so good.”
Simeon Saydee, 42, whose young daughter is an Ebola survivor, said, “I will take the vaccine and encourage my family to take it.”
Austin W. Doe of the United Methodist University, (UMU) said, “Whatever the case is, the vaccine is meant to protect me, and so I will take it.”
Dr. Moncef Slaoui, chairman of global vaccines at GSK, described the arrival of the vaccine in Liberia as a major achievement, noting: “The initial phase one data we have seen are encouraging and give us confidence to progress to the next phases of clinical testing, which will involve the vaccination of thousands of volunteers, including frontline healthcare workers. If the candidate vaccine is able to protect these people, as we hope it will, it could significantly contribute to efforts to bring this epidemic under control and prevent future outbreaks.
“It is important to remember that this vaccine is still in development and any potential future use in mass vaccination campaigns will depend on whether the WHO, regulators and other stakeholders are satisfied that the vaccine candidate provides protection against Ebola without causing significant side-effects and how quickly large quantities of vaccine can be made.”
However, GSK did acknowledged that the declining number of cases in Liberia will make it harder to find out whether the vaccine works and this begs the obvious question as to whether the trials can result in any concrete, legitimate optimism.
“Clearly it is good news that new cases of Ebola appear to be falling, and we hope this trend continues,” said a spokesperson. “Lower incidence of Ebola does increase the chance that the planned trials may take longer to complete; and if cases drop very low, they may not be able to answer the question about whether the investigational vaccines are able to offer protection from the disease. However, we are absolutely committed to going ahead as planned to see if we can gain the information we need to help with this outbreak or prevent future outbreaks.”
Meanwhile, Dr. Jeremy Farrar, director of the Wellcome Trust, which is funding a trial of the vaccine in UK and Mali and parallel studies of other vaccines in Geneva, Gabon, Kenya and Guinea, said: “This week we’ve heard encouraging news from West Africa, indicating that we may at last have reached a turning point in what has been the worst Ebola outbreak in history. Mali has been declared free from the disease and schools in Guinea reopened, restoring some sense of normality for those communities.”
Still, a number of eminent Liberians hold reservations, expressing the hope that Liberians participating in the trial not just be informed that it is a trial vaccine, but will be given full disclosure of any potential side effects.
”If a Bassa woman is taking the trial vaccine, the possible side effects should be explained to her in Bassa so that she is well aware of the risks. This has to be done according to our Liberian context,” said an eminent female Liberian lawyer who asked not to be named.