Bioethics Blogs

Nubia – An Ebola Survivor Orphaned by Vaccine Policy

Séverine Caluwaerts and Françoise Baylis lament the fact that in an epidemic as deadly as Ebola, pregnant women were denied access to potentially life-saving vaccination solely on the grounds of pregnancy.

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In August 2015 an effective Ebola vaccine (Merck, rVSV-ZEBOV vaccine) became available for people who had been exposed to a case of Ebola virus disease. In ideal circumstances vaccination would happen immediately or very shortly after exposure. In practice, however, not all at-risk individuals were eligible for vaccination. To explain, the rVSV vaccine was not tested in pregnant women because of a theoretical risk to the developing fetus. So, when this vaccine became available, doctors were not authorized to give it to pregnant women who had been exposed to Ebola.

This does not mean that no pregnant women were vaccinated against Ebola. There was no standard pregnancy testing prior to vaccination and so women who did not know that they were pregnant or who did not disclose their pregnancy status would have been vaccinated. Women who were obviously pregnant, however, or who did disclose that they were pregnant, would not have been vaccinated.

Nubia, 7 months old. Photo Credit and Copyright: Médecins Sans Frontières

The health care workers administering the vaccine knew from a previous epidemic with the Ebola Zaire strain that mortality in pregnant women was more than 50%. As well, in the earlier epidemic 15 infants were born to Ebola-positive women and all of them died within 21 days of birth (presumably of Ebola). Considering these facts – an extremely high mortality rate for pregnant woman and not a single baby having survived transplacental Ebola – many of the doctors wanted to vaccinate pregnant women who had been exposed to the virus.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.