An Ebola Vaccine Is Not the Answer

Instead, we need a treatment and better quarantine measures.
Reuters

In a widely shared Onion article from a few days ago, scientists "announced" that an Ebola vaccine was still 50 white people away. This was a jab at pharmaceutical companies, who, cynics think, will only set their R&D wheels in motion if there's money on the horizon. Hundreds of poor Africans die? No drugs. Old rich men can't have sex? All the drugs.

That's not entirely true, of course. It does take a big pharmaceutical company to get a vaccine approved for use in humans, but drug companies aren't evil—at least not irrationally so. They tend to throw resources into vaccine development if there's a chance that they might recoup their investments. GlaxoSmithKline, for example, is already pretty far along in developing a vaccine for malaria.

But malaria kills a child every minute. Meanwhile, here's a look at how many people die from Ebola compared with other deadly diseases:

Olga Khazan

Ebola's on there, I promise. It's just that, with 900 or so deaths, it's barely a blip compared to the others. Ebola is horrifying, but it's also sporadic—between the big 2001 outbreak and this one, only a few dozen people have gotten sick every year or two. And the current outbreak has spread among a handful of poor countries that all have weak health infrastructure. Drug companies aren't eager to develop a vaccine if they aren't sure who would buy it.

That's why the job of funding vaccines for diseases like Ebola usually falls to governments. And in this case, the U.S. government is actually working on a vaccine that has already been shown to work in monkeys. If it proves effective in humans, it could start to be used as early as next year.

But even if a vaccine works, it would be a stretch to say we could confidently use it to prevent another Ebola outbreak, like we did with smallpox or (largely) with polio:

Ebola is too unpredictable. The last outbreak occurred in 2012 in the Democratic Republic of Congo, which is 2,500 miles from Sierra Leone, the heart of the current epidemic. Short of vaccinating the entire continent of Africa, there's no good way to predict who is going to get the disease next. 

"We don't know where the next outbreak is going to be," Kartik Chandran, an associate professor of microbiology and immunology at Albert Einstein College of Medicine, told me. "It strikes like lightning and then disappears." 

There are several strains of Ebola. The current strain is ZEBOV, or Zaire virus, but there are also Sudan and Cote d'Ivoire versions. A vaccine would have to work against all of them.

Vaccines don't work that well in fast-moving epidemics. There are a few things you can do with a vaccine once an outbreak starts. One is immunizing healthcare workers and the families of infected patients. Sometimes doctors try "ring vaccination," or targeting residents of villages on the perimeter of the outbreak in an attempt to isolate and quash it.

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Olga Khazan is a staff writer at The Atlantic, where she covers health.

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