MSF DRC EBOLA: MSF calls for broader access to ERVEBO® vaccine during Bundibugyo Ebola outbreak
9 November - As the Bundibugyo Ebola outbreak continues in the Democratic Republic of Congo (DRC), Médecins Sans Frontières (MSF) is calling for rapid expansion of access to ERVEBO®, the only Ebola vaccine currently available at scale. While vaccines specifically developed against the Bundibugyo virus are still under development and unlikely to be available in the near term, growing evidence and encouraging field observations suggest that ERVEBO® could help protect more people at risk today.
No licensed vaccine currently exists specifically for Bundibugyo ebolavirus. While several candidate vaccines are under study, results are still months away, and for children under 12, evidence generation and potential access to Bundibugyo-specific vaccines may take even longer. By contrast, ERVEBO® is a licensed vaccine with a well-established safety profile, extensive operational experience from previous Ebola responses in DRC, and is currently authorized for use in individuals aged one year and older.
“For MSF, the absence of a Bundibugyo-specific vaccine should not prevent the use of the only vaccine currently available", said Guyguy Manangama, epidemiologist and deputy director of operations at MSF. "Every month spent waiting for dedicated tools leaves healthcare workers, frontline responders, contacts of confirmed cases and affected communities exposed to a potentially deadly disease."
"Expanding access to ERVEBO® offers the best immediate opportunity to help reduce severe illness and deaths while research on Bundibugyo-specific vaccines continues. Restrictions linking ERVEBO® vaccination to research protocols should be lifted so that available doses can be deployed rapidly to protect those most at risk." - Guyguy Manangama, epidemiologist and deputy director of operations at MSF
At present, access to vaccination remains highly restricted.
Frontline workers may be vaccinated through cumbersome research protocols or compassionate-use mechanisms, while contacts of confirmed Ebola cases generally only have access through ongoing clinical trials. Given the strict requirements of these trials, only a small fraction of people who could benefit from vaccination are likely to be enrolled, far short of what would be needed for broad public health deployment. This leaves many at-risk populations without access to vaccination despite the continued spread of the outbreak.
At the same time, evidence supporting the potential role of ERVEBO® continues to grow:
Although ERVEBO® was not specifically designed for the Bundibugyo virus, a growing body of scientific evidence suggests it may still help protect people exposed to it. Animal studies and immunological data from research in vaccinated individuals have shown encouraging signs that the immune response triggered by ERVEBO® may also recognize and respond to Bundibugyo virus.
"Beyond evidence from previous research, MSF teams involved in Ebola responses in the DRC have observed encouraging signals among people vaccinated before the seventeenth Ebola outbreak, including fewer confirmed cases and indications of lower mortality among those with confirmed infection”, said Etienne Gignoux, epidemiologist and director of the Department of Epidemiology at Epicentre, the epidemiology research centre of MSF.
"In an outbreak, decisions must often be made before the evidence is complete, and the tools are ideal,” said Etienne Gignoux. “Public health authorities must balance the need for research with the urgent need to save lives.”
Broader vaccination will only be possible if adequate vaccine supplies are made available:
The DRC Ministry of Health has already expanded access to ERVEBO® through compassionate-use mechanisms. However, these efforts require additional resources and a larger release of doses from existing stockpiles, subject to SAGE's endorsement at its next meeting, on November 17. In August, the DRC government, with support from Africa CDC, requested 500,000 doses of ERVEBO® from the World Health Organization's International Coordinating Group (ICG) on Vaccine Provision to support a broader vaccination strategy. Only 70,000 doses were released. This shortfall is particularly concerning as the outbreak continues to spread and cases have been reported beyond the DRC's borders, creating the prospect of additional vaccination needs in affected and at-risk countries.
MSF is therefore calling on Merck, global health authorities and partners to ensure vaccine allocations match the scale of public health needs and enable a meaningful expansion of vaccination.
MSF also stresses that vaccination alone will not bring the outbreak under control:
It must complement, not replace, all other essential pillars of the Ebola response. Surveillance, rapid case detection, laboratory diagnosis, contact tracing, quality clinical care, infection prevention and control measures, safe and dignified burials, community engagement and support for frontline health workers all require urgent reinforcement.
More broadly, the current outbreak highlights persistent gaps in global epidemic preparedness. Governments, donors, researchers and manufacturers must invest in vaccine platforms and manufacturing technologies that can rapidly produce and ensure availability of effective and affordable vaccines during emerging outbreaks. Communities facing future epidemics should not be left waiting months or years for disease-specific tools to become available.
Note to editors:
For more information, see the MSF Access Campaign briefing, Vaccines and the 2026 Bundibugyo Ebola Disease Outbreak: Access Gaps and Recommendations, which examines current vaccine access challenges during the outbreak and proposes recommendations to ensure equitable access to effective vaccines.