Implementation of a Large-Scale Ebola Vaccination Campaign in Rwanda

Background/Objectives: Ebola Virus Disease (EVD) remains a public health threat in sub-Saharan Africa. The 10th Ebola outbreak in the Democratic Republic of the Congo (DRC) in 2018–2020 led the Rwanda Ministry of Health to launch a large-scale Ebola vaccination campaign using the two-dose Ad26.ZEBOV and MVA-BN-Filo regimen. The campaign was implemented by local organizations, the Center for Family Health Research and Rinda Ubuzima, in partnership with the Rwanda Biomedical Center. Methods: The campaign targeted those who live near or routinely cross the Rwanda/DRC border and unvaccinated first responders. Children <2 years and pregnant women were excluded. Results: Between December 2019 and September 2021, 219,775 individuals attended vaccination sites and 216,108 received the first dose. Of those, 110,699 (51.2%) were adults (≥18 years) and 105,409 (48.8%) were children aged 2–17 years. A total of 118,048 (54.6%) were women and 98,060 (45.4%) were men. Of all first-dose clients, 203,303 (94.1%) received the second dose. Participants who were older, male, in Rubavu district, and urban were more likely (p < 0.05) to be lost between the first and second dose. Most individuals who were ineligible for the second dose were women who fell pregnant after the first dose. Conclusions: Findings highlight that a large-scale vaccination campaign, including remote areas, is feasible with high adherence despite the concurrent COVID-19 pandemic. Early stakeholder engagement and local leadership were critical to success. Future studies of reasons for non-adherence, as well as strategies to integrate family planning into campaign activities to reduce ineligibility due to pregnancy, are warranted.