The first Ebola vaccine was approved in 2019. Developed by the Public Health Agency of Canada, rVSV-ZEBOV is based on an attenuated recombinant vesicular stomatitis virus, genetically modified to express a surface glycoprotein of Zaire ebolavirus, and is estimated to be 97.5% effective. In the Kivu Ebola epidemic of 2018โ20, a ring vaccination strategy was employed to protect direct and indirect contacts of infected people, as well as health workers, and around 300,000 people were vaccinated with rVSV-ZEBOV. A second vaccine was approved in 2020; this uses two different doses โ a vector based on human adenovirus serotype 26 used to prime, boosted around eight weeks later by modified vaccinia Ankara (based on a heavily attenuated vaccinia virus) โ and is not suitable for response to an outbreak. The efficacy is unknown. Multiple other vaccine candidates are in development to prevent Ebola, including replication-deficient adenovirus vectors, replication-competent human parainfluenza 3 vectors, and virus-like nanoparticle preparations.