A World Health Organization expert meeting on Ebola vaccines proposed urgent safety and efficacy studies in response to the outbreak in West Africa. One approach to communicable disease control is ring vaccination of individuals at high risk of infection due to their social or geographical connection to a known case.
This paper describes the protocol for a novel cluster randomised controlled trial design which uses ring vaccination. In the Ebola ça suffit ring vaccination trial, rings are randomised 1:1 to (a) immediate vaccination of eligible adults with single dose vaccination or (b) vaccination delayed by 21 days. Vaccine efficacy against disease is assessed in participants over equivalent periods from the day of randomisation. Secondary objectives include vaccine effectiveness at the level of the ring, and incidence of serious adverse events. Ring vaccination trials are adaptive, can be run until disease elimination, allow interim analysis, and can go dormant during inter-epidemic periods.
This Emerging Infectious Diseases research paper, ‘The ring vaccination trial: a novel cluster randomised controlled trial design to evaluate vaccine efficacy and effectiveness during outbreaks, with special reference to Ebola’ by researchers from the London School of Hygiene and Tropical Medicine is based on their ‘Modelling Ebola in West Africa’ research commissioned by ELRHA and funded by The Department for International Development (DFID) and the Wellcome Trust.
Ebola ça suffit ring vaccination trial consortium. The ring vaccination trial: a novel cluster randomised controlled trial design to evaluate vaccine efficacy and effectiveness during outbreaks, with special reference to Ebola. BMJ (2015) : h3740. [DOI: 10.1136/bmj.h3740]
Ring vaccination for Ebola : a novel approach to evaluate vaccine efficacy and effectiveness during an outbreak