From the article:
NEW DELHI — The Democratic Republic of the Congo is currently facing the most severe Ebola outbreak in its history, with over 400 deaths confirmed since August, according to the World Health Organization. Much hope is pinned on a new vaccine — not yet licensed, but described by WHO as “safe and protective” — which has so far been used to immunize more than 60,000 people deemed most at risk of infection.
But one key group is denied access: Since the vaccine has not been tested for use during pregnancy, it is not being offered to pregnant women.
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Carleigh Krubiner, a policy fellow at the Center for Global Development and one of the lead authors of a recent report on maternal immunization, noted that pregnant and breastfeeding women are often at greater risk of exposure to the virus, because of caregiving responsibilities and proximity with children. “There's significant fear that's been documented among women [in DRC] who are unable to receive the vaccine and know they're at disproportionate risk of exposure just given some of the social roles,” she told Devex.
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Even as recently as the West Africa Ebola outbreak of 2014-2016, opportunities to “gather more robust data on pregnancy,” which could have helped to protect pregnant women the next time around, were missed, Krubiner said.
“There were recommendations to include pregnant women in those trials, especially given the risk-benefit calculus at the time, and ultimately for a whole host of reasons those recommendations were not taken up,” she said. “The cost of doing this research versus the cost of essentially denying women access to something that could be highly beneficial, there's really no comparison. We can't afford to leave this group unprotected.”
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“The development community [as funders and advocates] really does hold a lot of power to reshape the agenda in a way that is much more inclusive to address the needs of pregnant women and their babies,” Krubiner said.
While a small but rising number of vaccines are now being developed specifically for use during pregnancy, pregnant women are still rarely included in the development of vaccines targeted at more general populations. But with increasing attention being paid to vaccine research for epidemics — through initiatives such as the Coalition for Epidemic Preparedness Innovations, a public-private coalition that aims to speed up vaccine research, and WHO’s blueprint for research and development — there is an opportunity for change, Krubiner said.
“There's a lot of effort right now to try and bring to market new and innovative vaccines so that the next time there is an outbreak of Lassa fever or Nipah virus or even Ebola we will have more tools at our disposal … All of those efforts that are happening now can be leveraged to proactively include pregnant women in the response,” she said.
“I think we have a moment right now to learn from our past failures and to really change, to shift the paradigm.”