• The Strategic Advisory Group of Experts (SAGE) on Immunization convened in May 2024 to update Ebola vaccination recommendations. 

• They reviewed two vaccines: rVSVΔG-ZEBOV-GP (Ervebo) by Merck & Co. and Ad26.ZEBOV with MVA-BN-Filo (Zabdeno and Mvabea) by Janssen Pharmaceutica. 

• Ervebo, a single-dose vaccine, showed 100% efficacy in non-pregnant adults and sustained antibody levels for at least five years. 

• It has a good safety profile despite higher local and systemic adverse events than controls. 

• Ervebo is particularly effective for rapid outbreak response through ring vaccination and is recommended for healthcare workers (HCWs) and frontline workers (FLWs) in at-risk areas, with revaccination suggested if outbreaks occur more than six months after initial vaccination.

• Zabdeno and Mvabea, a two-dose regimen, demonstrated approximately 53% survival in animal studies against a fully lethal dose, with documented antibody duration for at least five years. 

• It is slightly more reactogenic than controls but has no elevated risk of serious adverse events. 

• However, it is less suitable for rapid outbreak response due to its two-dose requirement and is recommended for low-risk areas if resources allow. 

• The overall strategy favors Ervebo for immediate high-level protection during outbreaks, while Zabdeno and Mvabea are considered for broader, preventive vaccination efforts.

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