Our Global Voices Posts

I have seen Ebola. Now you have a vaccine.

Posted on by Rosalind Carter-Epidemiologist, Global Immunization Division

Debut of preventive use of Ebola Virus Disease (EVD) vaccine for health care and frontline workers in Uganda before an outbreak

Rosalind Carter - Epidemiologist, Global Immunization Division
Rosalind Carter – Epidemiologist, Global Immunization Division

For the first time, an unlicensed Ebola vaccine tested in clinical trials during the West African outbreak was offered to health care workers (HCWs) and other front line workers (FLWs) working in facilities bordering the outbreak areas in the Democratic Republic of Congo (DRC) under “compassionate use.”   Nearly 90,000 community members, HCWs and FLWs have been vaccinated in DRC using a ring vaccination protocol (as of March 24, 2019).

Also for the first time, in countries bordering DRC, preparedness efforts include offering the Ebola vaccine to HCW and FLW working at health facilities and border crossings just across the border from Ebola hotspots in DRC. WHO and the ministries of health lead the vaccination program. CDC is providing technical expertise and our experience continues to be valued in each new country undertaking Ebola vaccination. By April 2019, more than 4,100 HCWs and FLWs in 13 districts in Uganda, and nearly 1,500 in 3 states in South Sudan, have been vaccinated.

Successfully implementing an experimental vaccine in field conditions and convincing HCW and FLW to receive a vaccine before a case occurred in Uganda was a major achievement. Not everyone offered vaccine took it and we learned a lot along the way and honed communication messages. On the first day of vaccination at the first site in Ntoroko District, a health center in a remote area near Lake Victoria, we had the usual “first day” challenges with staff new to their roles, and logistical challenges in getting all the required supplies to the sites. Several hours after we opened the site we successfully vaccinated the first participant, a senior clinical officer at the Health Center.   During the 30-minute post vaccination observation period, I sat down to chat with him and thank him for his patience. When I asked why he had decided to take the vaccine he responded: “I was a medical officer during the 2008 outbreak of Ebola Bundibugyo in the next District. We did not have a vaccine then and I watched people die. Now you bring me a vaccine. Of course, I want it. In addition, I am making sure all my staff at the health center are getting it today. It will make us feel safe if this Ebola comes to our facility.”   Throughout the day, he brought all of the nurses, clinical officers and laboratory staff to the vaccination site and stayed with them, providing emotional support for those who were scared and encouraged. It was an incredible display of leadership and caring—while also respecting individual level decision-making and the right of each person to consent to vaccine or not.   It was a stressful time for the team supervising the work, but the inspiration of this first vaccination carried me through many long days and nights to come as we continued to roll out to new sites and new Districts.

Because the vaccine is unlicensed, it must be used under a trial protocol with vaccination teams trained in good clinical practices, and individuals must provide informed consent. Because pregnant and breast feeding women are excluded from vaccination, programs offered pregnancy testing onsite.

With a new, unlicensed vaccine, there is a small pool of staff with field experience. Many of the WHO staff who worked on the vaccine trial in Guinea were fully engaged with the vaccination work in DRC.   CDC’s experience with the Ebola vaccine as part of the STRIVE vaccine trial in Sierra Leone created a small cadre of epidemiologists who have provided valuable assistance in the field for the current outbreak on delivering vaccine in health care facilities.

Because the Ebola vaccine trials conducted during the 2014-2016 West Africa outbreak in Guinea, Liberia and Sierra Leone demonstrated the safety and efficacy of the rVSV-ZEBOV (Merck) vaccine, vaccine is now a standard part of an Ebola outbreak response.

 

 

Posted on by Rosalind Carter-Epidemiologist, Global Immunization Division

Readying the World for Maternal RSV Vaccine

Updated from the original posting on Vaccines Work on February 18, 2019 By getting vaccinated in pregnancy, mothers can safeguard themselves and their infants in the first few vulnerable months of life against certain diseases. This strategy is a powerful approach for reaching two stages of life often underserved by current immunization programs—pregnancy and early Read More >

Posted on by By Dr. Bruce Innis, Global Head, Respiratory Infections & Maternal Immunization, PATH Center for Vaccine Access and Immunization, and AMI Strategic Leadership and Dr. Sadaf Khan, PATH Senior Program Officer and AMI Maternal & Newborn Health Technical AdvisorTags , , ,

Promoting access to and use of clean and safe water to stop hepatitis E

GoersWindhoek

My name is Dr. Matthew Goers, an Epidemic Intelligence Service (or EIS) officer with CDC’s Division of Global Health Protection. Our division works with other countries and international organizations to respond to international disasters, disease outbreaks, and humanitarian crises. In September of 2017, Namibia began reporting sporadic cases of acute jaundice, abdominal pain, and fatigue. Read More >

Posted on by Dr. Matthew GoersTags , , ,

Thirty years of a Unique Partnership to End Polio-GPEI

chad-polio-vaccination-innovation-outbreak

In 1988, CDC joined three other partners (World Health Organization (WHO), United Nation International Children Fund (UNICF) and Rotary International to launch the ambitious Global Polio Eradication Initiative (GPEI). The world was a dangerous place with respect to polio. A case of polio occurred every 90 seconds, meaning 350,000 children had paralytic polio every year. Read More >

Posted on by Dr. John F. Vertefeuille - Incident Manager for the CDC Polio Response and Branch Chief of the Polio Eradication Branch, Global Immunization Division, Center for Global Health, Centers for Disease Control and PreventionTags , , ,

Getting to the Heart of the Matter in Latin America and the Caribbean

A blood pressure screening in Barbados raises awareness of hypertension and cardiovascular disease.

“I don’t get migraines, I don’t get dizzy spells any longer,” explains Ms. Williams, a patient at a polyclinic on the Caribbean island nation of Barbados. “It is working for me where I have no problems now with high blood pressure. Yes, I’m hypertensive, but I’m controlled.” Ms. Williams was enrolled as a patient in Read More >

Posted on by Bethany Hall, Scientific Health Communications FellowTags

Rapid Detection Accelerates India’s Response to Nipah Outbreak

CDC is working internationally to build laboratory capacity so that disease can be identified at their source. Photo: CDC India

  On May 17, 2018, almost two weeks after his brother died of febrile illness, a male patient in his mid-twenties visited a hospital in Kerala, India, with a fever. A day later, he was dead — but not before his doctors noticed his symptoms were consistent with encephalitis.Recognizing the potential danger, they immediately sent Read More >

Posted on by Dr. Kayla Laserson, CDC India Country Director

Zambia: A regional leader in NPHI development and emergency management

Dr. Victor Mukonka, Director of the Zambia National Public Health Institute

The Zambia National Public Health Institute (ZNPHI) is young but is already emerging as a leader for public health in Southern Africa. We are proud of our growth over the past four years and the increasing role we have assumed in the region. As ZNPHI  Southern Africa’s first regional workshop on public health emergency management Read More >

Posted on by Dr. Victor Mukonka, Director of the Zambia National Public Health Institute

CDC works with countries to identify children infected with hepatitis B virus and generate the evidence for hepatitis B vaccine birth dose introduction

Anna Minta training the survey team

Around the world, approximately 257 million people are infected with hepatitis B virus (HBV), and about 700,000 die every year as result of the long-term, chronic health threats from HBV, including liver disease and cancer. But, such suffering can be prevented with a vaccine! More tragic still, newborn babies infected at birth by their mothers, Read More >

Posted on by Anna Akua Minta, (CDC/CGH/GID)

Community-based Surveys are Informing Local Cessation Smoking Campaigns for Indigenous Australians

Project leader Alyson Wright surveys a community member in Central Australia.

Australia is a global leader in tobacco control, with a continuous comprehensive strategy initiated in the late 1980s that includes advertising restrictions, price increases, plain packaging, and mass media campaigns. However, after three decades, limited progress has occurred with regard to smoking prevalence among Australia’s Aboriginal and Torres Strait Islander population. Cigarette smoking prevalence among Read More >

Posted on by Alyson Wright, National Centre for Epidemiology and Population Health, Australian National UniversityTags , ,

How Senegal is tracking the Silent Killer

How Senegal is tracking the Silent Killer At a packed clinic in the middle of Dakar, Senegal, a busy nurse secures a blood pressure cuff around a patient’s arm. “After I take the blood pressure, I record it here,” the nurse says enthusiastically, showing a patient treatment card to Dr. Monica LaBelle, a CDC Foundation Read More >

Posted on by Bethany Hall, MPH