Status and challenges of filovirus vaccines.

Vaccines that could protect humans against the highly lethal Marburg and Ebola viruses have eluded scientists for decades. Classical approaches have been generally unsuccessful for Marburg and Ebola viruses and pose enormous safety concerns as well. Modern approaches, in particular those using vector-based approaches have met with success in nonhuman primate models although success against Ebola has been more difficult to achieve than Marburg. Despite these successes, more work remains to be done. For the vector-based vaccines, safety in humans and potency in the face of pre-existing anti-vector immunity may be critical thresholds for licensure. The immunological mechanism(s) by which these vaccines protect has not yet been convincingly determined. Licensure of these vaccines for natural outbreaks may be possible through clinical trials although this will be very difficult; licensure may also be possible by pivotal efficacy studies in animal models with an appropriate challenge. Nevertheless, nonhuman primate studies have shown that protection against Marburg and Ebola is possible and there is hope that one day a vaccine will be licensed for human use.