FRIDAY, DECEMBER 23 , 2016
THE WASHINGTON POST
Politics & the Nation
Ebola vaccine shown to be ‘highly protective’ in big trial New study in Guinea involving a single shot showed 100% efﬁcacy BY
A RIANA E UNJUNG C HA
Scientists on Thursday announced a milestone in the fight against Ebola, reporting that a major trial of an experimental vaccine shows that it may be “highly protective” against the virus, which has infected nearly 30,000 people and killed 11,000 worldwide since 2013. Although the current outbreak has been contained, health officials fear that the deadly pathogen could return and have been racing to develop ways to stop it should that scenario unfold. The new study, led by the World Health Organization, was
based in a coastal region of Guinea known as Basse-Guinée. The vaccine showed 100 percent efficacy in protecting those who got it. More than 11,800 people participated in the trial. “While these compelling results come too late for those who lost their lives during West Africa’s Ebola epidemic, they show that when the next Ebola outbreak hits, we will not be defenseless,” Marie-Paule Kieny, the study’s lead author and WHO assistant director general for health systems, said in announcing the results. When preliminary findings were unveiled in July 2015, WHO Director General Margaret Chan called the vaccine a potential “game-changer.” Guinea was one of three West African nations hit hardest by Ebola beginning in 2014. Researchers are running two parallel studies of the same vaccine in
Sierra Leone and Liberia, the other epicenter countries. The vaccine used in the study, known as rVSV-ZEBOV and licensed by Merck, involves just a single shot. The U.S. Food and Drug Administration and the European Medicines Agency have designated it for streamlined regulatory approval. A number of other vaccines — developed by GlaxoSmithKline and the Beijing Institute of Biotechnology, among other groups — also have shown promise and are advancing in human trials. The Guinea trial, described in the Lancet, used an approach known as “ring vaccination,” which the researchers described as the same approach used to eradicate smallpox. It involves tracing all individuals who may have been in contact with every new person diagnosed with the virus, from relatives who live in the same household to visitors
and those who may have been in close contact with the infected person’s clothes or linens. In some cases, contacts of contacts also were considered to be at risk. Ultimately, researchers identified 117 “rings,” or clusters of people, for the study. Each was made up of an average of 80 people. At the beginning of the trial, which took place in 2015, when the virus was actively spreading in the region, the rings were randomly divided into two groups. One was to get the vaccine immediately and the other after a three-week delay. When the first results showed that the vaccine was working, everyone was offered it immediately. Those 18 and older got it initially, then children older than 6. The results were striking: In the group of 5,837 people who received the vaccine immediately, there were zero Ebola cas-
es. In the other group, which included those who got a delayed vaccination as well as those who were never vaccinated, there were 23 cases. Kieny and research team members from Guinea’s Health Ministry and other international partners also noted that vaccination appeared to create a type of “herd immunity” that indirectly protected people who had not been vaccinated. But more research will be needed to confirm this theory, they said. Two serious adverse events were reported after vaccination, with one participant spiking a fever and another suffering an allergic reaction. Everyone else either reported no side effects or very mild ones such as headache, fatigue and muscle pain. No effects were long term. Despite researchers’ caution that more studies are needed to confirm the vaccine’s safety for
children and other vulnerable groups, such as individuals with HIV, they are making plans to accelerate its rollout should future trials further confirm safety and effectiveness. Merck has committed to having 300,000 emergency doses available soon and to submit the licensing application to regulatory authorities by the end of 2017. In a commentary piece — optimistically titled “First Ebola virus vaccine to protect human beings?” — virologist Thomas Geisbert of the University of Texas wrote that the study data was so strong that it seemed that the vaccine “probably contributed to controlling the 2013–16 outbreak of Ebola virus disease in Guinea.” firstname.lastname@example.org More at washingtonpost.com/ news/health-environmentscience
U.S. population growth is lower than at any time since the Great Depression BY
T ARA B AHRAMPOUR
Last year the United States had the lowest rate of population growth of any year since the Great Depression, according to census figures released Tuesday. The milestone is largely the result of the aging of the population, with more deaths last year than at any time since 2000, according to William Frey, a demographer and senior fellow at the Brookings Institution. The nation grew by 0.695 percent between 2015 and 2016 to 323.1 million, down from 0.732 percent the previous year — the lowest increase since 19371938, when it was 0.6 percent. Immigration also declined, though for the past three years it has been higher than it had been since before the recession of 20072009. But the fall in the natural increase, from 4.07 to 3.84 per 1,000, reflecting fewer births and more deaths, is the lead cause of
the slowdown — and the trend is expected to continue, Frey said. “The aging of the population is the main thing,” he said. “We still have a positive natural increase, and there are other countries that don’t have that” — such as Germany and Japan. But in coming years the increase will continue to decline, with serious policy implications, he said. “We need to pay attention to the dependent older population who’s going to have to be taken care of, through Social Security and Medicare and general support for them.” At the same time, he cautioned that the United States will need to invest in immigrants who are helping to shore up the younger segment of the labor force. The latest numbers show some states being hit harder by population loss while others are on an upswing — shifts that could affect future statewide and national elections.
Western and Southern states such as Nevada, Arizona and Florida, which took big hits during and after the recession, have been growing recently, while states with higher costs of living, including New York and California, and Midwestern states such as Ohio and Illinois, have experienced a decline in growth as people have moved away. Migration out of California had stagnated during the recession and post-recession period, but now the Golden State appears to be losing more migrants to neighboring states, in a phenomenon known as domestic outmigration, Frey said. A similar pattern is occurring between New York and Southeastern states. Utah is now the fastest-growing state — its population increased 2 percent to 3.1 million — while North Dakota, the growth leader in 2014-2015, fell to become the 15th-slowest-growing state as its oil extraction economy withered.
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Illinois leads the nation in population losses for the third year in a row, with its largest domestic outmigration since 1990. Texas had the highest numeric gains, with growth in immigration, domestic migration and natural increase. Florida, which bled population during and after the recession, also ranks high because of immigration and domestic migration. California and New York, on the other hand, rank high on immigration and natural increase but are among the nation’s biggest losers in terms of domestic migration, ranking 49th and 51st, respectively. The District of Columbia registered its highest population count since the 1970s, at 681,170 — an upward trend that is expected to continue. The changes have important implications for future elections. Projecting current trends onto the 2020 Census, Frey calculated that Texas would gain three electoral
college votes, Florida would gain two, and Arizona, Colorado, North Carolina and Oregon would gain one each. Alabama, Illinois, Michigan, Minnesota, Ohio, Pennsylvania, Rhode Island and West Virginia would lose one apiece. Given this November’s voting, the shifts would result in Donald Trump netting two additional electoral college votes from Hillary Clinton. The changes imply that a lot more states could be competitive in national elections. Typically the Midwest and the Northeast have voted for Democrats while Southern and Southwestern states have voted for Republicans. But Barack Obama won some traditionally Republican states, and Trump picked up some traditionally Democratic ones. As domestic migration continues, Republicans will no longer be able to rely on wins in Southern states, and Democrats will have to play stronger defense in Northern industrial areas that they once
took for granted, Frey said, adding, “It’s kind of up for grabs right now.” Outmigration from areas with declining economies can create a vicious cycle, said Philip Cohen, a sociology professor at the University of Maryland. “When the good prospects are elsewhere, people with good prospects leave,” he said, adding, “The middle of the country is still hollowing out overall in the long term.” And as states such as California experience more outmigration, immigrants from Mexico and Central America could increasingly head directly to states such as North Carolina and Iowa, where there are jobs. Once they and their children become citizens, this could have electoral implications. “In the small towns where immigrants are going, they can have a big effect,” Cohen said. email@example.com Scott Clement contributed to this report.
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