{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:55:29Z","timestamp":1790920529727,"version":"4.1.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>This perspective synthesizes published evidence on Ebola vaccination and outbreak preparedness in Africa. Successful vaccination against Zaire ebolavirus has strengthened vaccine-based outbreak control but may also create a preparedness risk when public expectations exceed species-specific vaccine availability. We propose the Vaccine Expectation Gap, Vaccine Anticipation and Species-Specific Vaccine Literacy as linked, hypothesis-generating constructs, supported by a Preparedness Trust Contract for practical implementation. The framework draws on expectation-disconfirmation and crisis and emergency risk communication theories and distinguishes established evidence from interpretation and testable hypotheses. Recent Sudan virus and Bundibugyo virus outbreaks illustrate the relevance of this gap because licensed vaccines remain species-specific. Evidence is concentrated in Uganda, making broader East African application a hypothesis requiring empirical testing. If validated, the framework could strengthen risk communication, community trust and regional health-security planning.<\/jats:p>","DOI":"10.3389\/fpubh.2026.1899575","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:35:52Z","timestamp":1790919352000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The vaccination paradox: how East Africa\u2019s success in Ebola vaccine preparedness may be creating new public expectations for future outbreaks"],"prefix":"10.3389","volume":"14","author":[{"given":"Okechukwu Paul-Chima","family":"Ugwu","sequence":"first","affiliation":[{"name":"Department of Research, Publication and Extension, Kampala International University","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chinyere Nneoma","family":"Ugwu","sequence":"additional","affiliation":[{"name":"Department of Research, Publication and Extension, Kampala International University","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Godson Emeka","family":"Anyanwu","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Faculty of Biomedical Sciences, Kampala International University","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Basajja","sequence":"additional","affiliation":[{"name":"Department of Research, Publication and Extension, Kampala International University","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryann Chiamaka","family":"Ebuoh","sequence":"additional","affiliation":[{"name":"Department of Human Anatomy, State University of Medical and Applied Sciences","place":["Igbo Eno, Enugu, Nigeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1016\/S0140-6736(16)32621-6","article-title":"Efficacy and effectiveness of an rVSV-vectored vaccine in preventing Ebola virus disease: final results from the Guinea ring vaccination, open-label, cluster-randomised trial","volume":"389","author":"Henao-Restrepo","year":"2017","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"360","DOI":"10.15585\/mmwr.mm7316a1","article-title":"Use of Ebola vaccines \u2013 worldwide, 2021\u20132023","volume":"73","author":"Kallay","year":"2024","journal-title":"Morb Mortal Wkly Rep"},{"key":"ref3","volume-title":"Ebola Disease","year":"2025"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1056\/NEJMra2607216","article-title":"Bundibugyo virus disease in 2026 \u2014 clinical and 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