The World Health Organization says Congo will start using a second experimental Ebola vaccine, as efforts to stop the spiraling outbreak are stalled and Doctors Without Borders criticizes vaccination efforts to date.

200,000 people receive Ebola vaccine in Congo

Since this outbreak was declared on August 2018, more than 200,000 people have received doses of a vaccine made by Merck which will continue to be used in Congo. The U.N. health agency in a statement Monday says the second vaccine, made by Johnson & Johnson, will be used from October in areas where Ebola is not actively spreading.

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Separately, Doctors Without Borders seeks an independent committee to manage Ebola vaccinations to improve transparency and increase access. The medical charity alleges that WHO is “restricting the availability of the vaccine in the field” and limiting eligibility criteria. Deep distrust along with political instability and deadly violence has severely undermined efforts by public health authorities in Congo to curb the outbreak by tracing and vaccinating those who may have come into contact with infected people.

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A global health emergency

Health experts agree the experimental Ebola vaccine has saved multitudes in Congo. But after nearly a year and some 171,000 doses given, the epidemic shows few signs of waning. The virus has killed more than 1,700 people and has now arrived in the region’s largest city, Goma. The World Health Organization last week declared the outbreak a global health emergency.

During the 2014-16 Ebola epidemic in West Africa, which left more than 11,300 people dead, health workers could only dream of a vaccine with a 97.5 percent effectiveness rate that could improve the odds of survival even in those already infected.

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WHO says as many as 90 percents of those eligible for vaccination have accepted it, but that figure only includes those who gave contact tracers enough information to be included on a list. The success rate excludes those who distrusted health workers and fled or those who couldn’t be found in the first place.

Health workers have been using what is known as a ring vaccination strategy: The vaccine is first given to those who were in close contact with a sick person. Then a second so-called ring is created by giving the vaccine to those who were in contact with those people.

Because of the difficulties in making that strategy work, some people didn’t get vaccinated until they had already been infected with the virus, and they developed Ebola anyway. That increased doubts about the vaccine in communities where the public health campaigns led by outsiders already were viewed with suspicion and hostility.

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“The rumors were if you got vaccinated you would die,” said Liboke Kakule Muhingi, a 43-year-old farmer in Mangina, where the epidemic began last August.