Postexposure Prophylaxis With rVSV-ZEBOV Following Exposure to a Patient With Ebola Virus Disease Relapse in the United Kingdom: An Operational, Safety, and Immunogenicity Report.
BACKGROUND
In October 2015, 65 people came into direct contact with a healthcare worker presenting with a late reactivation of Ebola virus disease (EVD) in the United Kingdom. Vaccination was offered to 45 individuals with an initial assessment of high exposure risk.


METHODS
Approval for rapid expanded access to the recombinant vesicular stomatitis virus-Zaire Ebola virus (rVSV-ZEBOV) vaccine as an unlicensed emergency medicine was obtained from the relevant authorities. An observational follow-up study was carried out for 1 year following vaccination.


RESULTS
Twenty-six of 45 individuals elected to receive vaccination between 10 and 11 October 2015 following written informed consent. By day 14, 39% had seroconverted, increasing to 87% by day 28 and 100% by 3 months, although these responses were not always sustained. Neutralizing antibody responses were detectable in 36% by day 14 and 73% at 12 months. Common side effects included fatigue, myalgia, headache, arthralgia, and fever. These were positively associated with glycoprotein-specific T-cell but not immunoglobulin (Ig) M or IgG antibody responses. No severe vaccine-related adverse events were reported. No one exposed to the virus became infected.


CONCLUSIONS
This paper reports the use of the rVSV-ZEBOV vaccine given as an emergency intervention to individuals exposed to a patient presenting with a late reactivation of EVD. The vaccine was relatively well tolerated, but a high percentage developed a fever ≥37.5°C, necessitating urgent screening for Ebola virus, and a small number developed persistent arthralgia.
['Davis|Chris|C|', 'Tipton|Tom|T|', 'Sabir|Suleman|S|', 'Aitken|Celia|C|', 'Bennett|Susan|S|', 'Becker|Stephan|S|', 'Evans|Tom|T|', 'Fehling|Sarah Katharina|SK|', 'Gunson|Rory|R|', 'Hall|Yper|Y|', 'Jackson|Celia|C|', 'Johanssen|Ingolfur|I|', 'Kieny|Marie Paule|MP|', 'Mcmenamin|Jim|J|', 'Spence|Elizabeth|E|', 'Strecker|Thomas|T|', 'Sykes|Catie|C|', 'Templeton|Kate|K|', 'Thorburn|Fiona|F|', 'Peters|Erica|E|', 'Henao Restrepo|Ana Maria|AM|', 'White|Beth|B|', 'Zambon|Maria|M|', 'Carroll|Miles W|MW|', 'Thomson|Emma C|EC|']
D000914:Antibodies, Viral D046129:Ebola Vaccines D029043:Ebolavirus D005500:Follow-Up Studies D019142:Hemorrhagic Fever, Ebola D006801:Humans D056990:Post-Exposure Prophylaxis D012008:Recurrence D006113:United Kingdom
rVSV-ZEBOV Ebola virus vaccine T cell