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Malaysian Society of Infectious Diseases & Chemotherapy

Guidelines for Adult Immunisation

Content

Message from Editor

Editorial Panel

Adult Immunisation Schedule

Contraindications and Special Considerations

Temporary Deferral of Immunisation

Route and Site of Administration

Post Vaccination

Anaphylaxis

Vaccine Storage and Disposal of Vaccines

Vaccine Combinations

Multiple Vaccinations

Adverse Event Following Immunisation (AEFI)

Immunosenescence

Cholera

COVID-19

Dengue

Diphtheria

Tetanus

Pertussis

Haemophilus influenzae type b

Hepatitis A

Hepatitis B

Human Papillomavirus (HPV)

Influenza

Japanese Encephalitis (JE)

Measles

Mumps

Rubella

Meningococcal Disease

Mpox

Pneumococcal Disease

Poliomyelitis

Rabies

Respiratory Syncytial Virus (RSV)

Typhoid Fever

Chickenpox (Varicella)

Yellow Fever

Shingles (Zoster)

Passive Immunisation

Avian Influenza

Chikungunya

Clostridioides difficile

Ebola

Human Immunodeficiency Virus (HIV)

Malaria

Zika

Adults Who Missed Childhood Immunisation

Older Adults and Patients With Chronic Ilnesses

Healthcare workers

Human Immunodeficiency Virus (HIV)

Immunocompromised Patients

Miscellaneous Groups

Travelers

Vets & Animal Handlers

Abbreviations

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Future Vaccines

Ebola

In this chapter:

Introduction

Ebola virus disease (EVD) is caused by the Ebola virus (EBOV), a linear non-segmented RNA virus that belongs to the Orthoebolavirus genus of the Filoviridae family. The EVD is rare but severe in humans and often fatal, with case fatality rates of 70%–90% when not treated.

The virus is mainly transmitted to humans from wild animals (especially bats) and spreads through human-to-human transmission via direct contact with blood, bodily fluids, or injured skin. The virus is highly transmissible and can be found in all body fluids of an infected person. If untreated, death from EVD occurs 7–10 days after the onset of symptoms. There is no specific treatment for EVD.

Ebola disease first occurred in 1976 in two simultaneous outbreaks: one outbreak was of Sudan virus disease in Nzara in what is now South Sudan, and the other outbreak was of Ebola virus disease in Yambuku, in what is now the Democratic Republic of the Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name.

Vaccines

More than 10 candidate Ebola vaccines (including monovalent, bivalent and multivalent candidates) have undergone or are currently undergoing clinical development at different trial phases, and two have obtained approval. Ebola vaccines are currently not available in Malaysia.

Table 29.7 Approved Ebola Virus Vaccines (licensed in certain countries)

Table 29.8 High-Risk Groups on the use of Ervebo Vaccine

Table 29.9 Other Approved Ebola Virus Vaccines (licensed in certain countries)

References

  1. International Committee on Virus Taxonomy, ICTV (2026) Filoviridae: Available at https://ictv.global/report/chapter/filoviridae/filoviridae/orthoebolavirus
  2. European Medicines Agency (EMA). (May 29, 2020). New vaccine for prevention of Ebola virus disease recommended approval in the European Union. Press release. https://www.ema.europa.eu/en/news/new-vaccine-prevention-ebola-virus-disease-recommended-approval-european-union
  3. Trad, M. A., Naughton, W., Yeung, A., et al (2017). Ebola virus disease: An update on current prevention and management strategies. Journal of Clinical Virology, 86, 5–13. https://doi.org/10.1016/j.jcv.2016.11.005
  4. S. Food and Drug Administration (December 19, 2019). First FDA-approved vaccine for the prevention of Ebola virus disease, marking a critical milestone in public health preparedness and response. Press release.
  5. World Health Organisation (2025). Ebola Disease. Available at:  https://www.who.int/news-room/fact-sheets/detail/ebola-disease
  6. World Health Organization (May 2024). Extraordinary meeting of the Strategic Advisory Group of Experts on Immunization on Ebola vaccination: conclusions and recommendations. Weekly Epidemiological Report, 99(27), 355–362. https://www.who.int/publications/i/item/WER-9927-355-362
  7. World Health Organization. (November 12, 2019). WHO prequalifies Ebola vaccine, paving the way for its use in high-risk countries. Press release https://www.who.int/news/item/12-11-2019-who-prequalifies-ebola-vaccine-paving-the-way-for-its-use-in-high-risk-countries
  8. Choi, M.J., Cossaboom, C.M., Whitesell, A.N., et al. (January 8, 2021). Use of Ebola vaccine: recommendations of the Advisory Committee on Immunization Practices, United States,2020. Morbidity and Mortality Weekly Report, 70(1):1–12. https://doi.org/10.15585/mmwr.rr7001a1
  9. Feldmann, H., Geisbert, T.W. (2011). Ebola haemorrhagic fever. Lancet, 377:849–62. https://doi.org/10.1016/S0140-6736(10)60667-8
  10. Malenfant, J.H., Joyce, A., Choi, M.J., et al. (2021). Use of Ebola Vaccine: Expansion of Recommendations of the Advisory Committee on Immunization Practices To Include Two Additional Populations, United States. Morb Mortal Wkly Rep ;71:290–292. DOI: http://dx.doi.org/10.15585/mmwr.mm7108a2
  11. Malvy, D., McElroy, A.K., de Clerck, H., Günther, S., and van Griensven, J. (2019). Ebola virus disease. Lancet 393:936–48. https://doi.org/10.1016/S0140-6736(18)33132-5
  12. Woolsey, C., & Geisbert, T. W. (2021). Current state of Ebola virus vaccines: A snapshot. PLoS pathogens, 17(12), e1010078. https://doi.org/10.1371/journal.ppat.1010078
  13. Jenkin, D., Makinson, R., Sanders, H., et al. (May 2025). Safety and immunogenicity of a bivalent Ebola virus and Sudan virus ChAdOx1 vectored vaccine in adults in the UK: an open-label, non-randomised, first-in-human, phase 1 clinical trial. The Lancet Microbe, Volume 6, Issue 5, 101022 https://doi.org/10.1016/j.lanmic.2024.101022