{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:17:03Z","timestamp":1785421023925,"version":"3.56.0"},"reference-count":52,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/029chgv08","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020171","name":"Foreign, Commonwealth and Development Office","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100020171","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/037wke960","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004331","name":"Johnson & Johnson","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004331","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/008j2vk87","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Janssen Vaccines and Prevention B.V."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background\/Objectives: Ebola Virus Disease (EVD) remains a public health threat in sub-Saharan Africa. The 10th Ebola outbreak in the Democratic Republic of the Congo (DRC) in 2018\u20132020 led the Rwanda Ministry of Health to launch a large-scale Ebola vaccination campaign using the two-dose Ad26.ZEBOV and MVA-BN-Filo regimen. The campaign was implemented by local organizations, the Center for Family Health Research and Rinda Ubuzima, in partnership with the Rwanda Biomedical Center. Methods: The campaign targeted those who live near or routinely cross the Rwanda\/DRC border and unvaccinated first responders. Children &lt;2 years and pregnant women were excluded. Results: Between December 2019 and September 2021, 219,775 individuals attended vaccination sites and 216,108 received the first dose. Of those, 110,699 (51.2%) were adults (\u226518 years) and 105,409 (48.8%) were children aged 2\u201317 years. A total of 118,048 (54.6%) were women and 98,060 (45.4%) were men. Of all first-dose clients, 203,303 (94.1%) received the second dose. Participants who were older, male, in Rubavu district, and urban were more likely (p &lt; 0.05) to be lost between the first and second dose. Most individuals who were ineligible for the second dose were women who fell pregnant after the first dose. Conclusions: Findings highlight that a large-scale vaccination campaign, including remote areas, is feasible with high adherence despite the concurrent COVID-19 pandemic. Early stakeholder engagement and local leadership were critical to success. Future studies of reasons for non-adherence, as well as strategies to integrate family planning into campaign activities to reduce ineligibility due to pregnancy, are warranted.<\/jats:p>","DOI":"10.3390\/vaccines14070588","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T10:41:01Z","timestamp":1782902461000},"page":"588","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementation of a Large-Scale Ebola Vaccination Campaign in Rwanda"],"prefix":"10.3390","volume":"14","author":[{"given":"Rosine","family":"Ingabire","sequence":"first","affiliation":[{"name":"Center for Family Health Research, Kigali P.O. Box 780, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Nyombayire","sequence":"additional","affiliation":[{"name":"Center for Family Health Research, Kigali P.O. Box 780, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Sayinzoga","sequence":"additional","affiliation":[{"name":"Rwanda Biomedical Center, Kigali P.O. Box 7162, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Baptiste","family":"Mazarati","sequence":"additional","affiliation":[{"name":"Rwanda Biomedical Center, Kigali P.O. Box 7162, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Mazzei","sequence":"additional","affiliation":[{"name":"Center for Family Health Research, Kigali P.O. Box 780, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karel Van","family":"Roey","sequence":"additional","affiliation":[{"name":"Janssen R&D, 2340 Beerse, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Kasigazi","sequence":"additional","affiliation":[{"name":"Center for Family Health Research, Kigali P.O. Box 780, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Placide","family":"Nshizirungu","sequence":"additional","affiliation":[{"name":"Gihundwe District Hospital, Rusizi P.O. Box 87, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oreste","family":"Tuganeyezu","sequence":"additional","affiliation":[{"name":"Gisenyi District Hospital, Rubavu P.O. Box 175, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabin","family":"Nsanzimana","sequence":"additional","affiliation":[{"name":"Rwanda Ministry of Health, Kigali P.O. Box 84, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal","family":"Sifa","sequence":"additional","affiliation":[{"name":"Center for Family Health Research, Kigali P.O. Box 780, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Japhet","family":"Niyonzima","sequence":"additional","affiliation":[{"name":"Center for Family Health Research, Kigali P.O. Box 780, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edouard","family":"Mirimo","sequence":"additional","affiliation":[{"name":"Center for Family Health Research, Kigali P.O. Box 780, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Mc Kenna","sequence":"additional","affiliation":[{"name":"Janssen R&D, 2340 Beerse, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Parker","sequence":"additional","affiliation":[{"name":"Rwanda Zambia Health Research Group, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Tichacek","sequence":"additional","affiliation":[{"name":"Rwanda Zambia Health Research Group, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jozef","family":"Noben","sequence":"additional","affiliation":[{"name":"Janssen R&D, 2340 Beerse, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8547-2004","authenticated-orcid":false,"given":"Kristin M.","family":"Wall","sequence":"additional","affiliation":[{"name":"Rwanda Zambia Health Research Group, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9150-3898","authenticated-orcid":false,"given":"Susan","family":"Allen","sequence":"additional","affiliation":[{"name":"Rwanda Zambia Health Research Group, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9475-5436","authenticated-orcid":false,"given":"Etienne","family":"Karita","sequence":"additional","affiliation":[{"name":"Center for Family Health Research, Kigali P.O. Box 780, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1038\/s41572-020-0147-3","article-title":"Ebola virus disease","volume":"6","author":"Jacob","year":"2020","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_2","unstructured":"Centers for Disease Control and Prevention (2022, June 12). Ebola Virus Disease Distribution Map: Cases of Ebola Virus Disease in Africa Since 1976, Available online: https:\/\/web.archive.org\/web\/20240228204858\/https:\/\/www.cdc.gov\/vhf\/ebola\/history\/distribution-map.html."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.15585\/mmwr.mm6850a3","article-title":"Ebola Virus Disease Outbreak-Democratic Republic of the Congo, August 2018\u2013November 2019","volume":"68","author":"Aruna","year":"2019","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1126\/science.364.6437.223","article-title":"Ebola outbreak continues despite powerful vaccine","volume":"364","author":"Cohen","year":"2019","journal-title":"Science"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1056\/NEJMsr1904253","article-title":"The ongoing Ebola epidemic in the Democratic Republic of Congo, 2018\u20132019","volume":"381","author":"Sparrow","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_6","unstructured":"World Health Organization (2019). Ebola Outbreak in the Democratic Republic of the Congo Declared a Public Health Emergency of International Concern, World Health Organization. Available online: https:\/\/www.who.int\/news\/item\/17-07-2019-ebola-outbreak-in-the-democratic-republic-of-the-congo-declared-a-public-health-emergency-of-international-concern."},{"key":"ref_7","unstructured":"World Health Organization (2019). WHO Adapts Ebola Vaccination Strategy in the Democratic Republic of the Congo to Account for Insecurity and Community Feedback, World Health Organization. Available online: https:\/\/www.who.int\/news\/item\/07-05-2019-who-adapts-ebola-vaccination-strategy-in-the-democratic-republic-of-the-congo-to-account-for-insecurity-and-community-feedback."},{"key":"ref_8","unstructured":"World Health Organization (2019). Statement on the Meeting of the International Health Regulations (2005) Emergency Committee for Ebola Virus Disease in the Democratic Republic of the Congo on 12th April 2019, World Health Organization. Available online: https:\/\/www.who.int\/news\/item\/12-04-2019-statement-on-the-meeting-of-the-international-health-regulations-(2005)-emergency-committee-for-ebola-virus-disease-in-the-democratic-republic-of-the-congo-on-12th-april-2019."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Bedford, J. (2019). Rwanda\u2013DRC Cross Border Dynamics, Social Science in Humanitarian Action Platform. Available online: https:\/\/www.socialscienceinaction.org\/resources\/rwanda-drc-cross-border-dynamics.","DOI":"10.7490\/f1000research.1117869.1"},{"key":"ref_10","unstructured":"Press, K.T. (2022, July 12). Rwanda-DR Congo Border Records Biggest Traffic in Africa, Rivals US\u2013Mexico. Available online: https:\/\/www.ktpress.rw\/2018\/05\/rwanda-dr-congo-border-records-biggest-traffic-in-africa-rivals-us-mexico\/."},{"key":"ref_11","unstructured":"Rwanda Biomedical Centre (2022, July 12). Combating Ebola, Inside UMURINZI, The Ebola Virus Disease Immunization Campaign, Rubavu District, Available online: https:\/\/rbc.gov.rw\/index.php?id=724."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"7190","DOI":"10.1016\/j.vaccine.2017.08.058","article-title":"Considerations for use of Ebola vaccine during an emergency response","volume":"37","author":"Walldorf","year":"2019","journal-title":"Vaccine"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1887","DOI":"10.1016\/S0140-6736(16)30394-4","article-title":"Mind the gap: Jumping from vaccine licensure to routine use","volume":"387","author":"Binka","year":"2016","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"10178","DOI":"10.1073\/pnas.1817329116","article-title":"Ebola vaccination in the Democratic Republic of the Congo","volume":"116","author":"Wells","year":"2019","journal-title":"Proc. Nat. Acad. Sci. USA"},{"key":"ref_15","first-page":"42","article-title":"Ebola virus in the Democratic Republic of the Congo: Advances and remaining obstacles in epidemic control, clinical care, and biomedical research","volume":"157","author":"Wendelboe","year":"2020","journal-title":"Chest"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Chowell, G., Tariq, A., and Kiskowski, M. (2019). Vaccination strategies to control Ebola epidemics in the context of variable household inaccessibility levels. PLoS Negl. Trop. Dis., 13.","DOI":"10.1101\/665646"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3192","DOI":"10.1080\/21645515.2021.1920872","article-title":"Leapfrogging with technology: Introduction of a monitoring platform to support a large-scale Ebola vaccination program in Rwanda","volume":"17","author":"Masyn","year":"2021","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_18","unstructured":"National Institute of Statistics of Rwanda (2022, July 12). Fourth Population and Housing Census, Rwanda, 2012: Rusizi District Profile, Available online: https:\/\/statistics.gov.rw\/sites\/default\/files\/2025-06\/Rusizi_District_Profile_0.pdf."},{"key":"ref_19","unstructured":"National Institute of Statistics of Rwanda (2022, July 12). Fourth Population and Housing Census, Rwanda, 2012: Rubavu District Profile, Available online: https:\/\/statistics.gov.rw\/sites\/default\/files\/2025-06\/Rubavu-District-Profile.pdf."},{"key":"ref_20","unstructured":"Ministry of Infrastructure of Rwanda (2022, July 12). Urbanization and Rural Settlement Sector, Strategic Plan 2012\/2013 to 2017\/2018; Ministry of Infrastructure of Rwanda: Kigali, Rwanda, Available online: https:\/\/www.mininfra.gov.rw\/fileadmin\/user_upload\/Mininfra\/Documents\/Housing_and_Urban_Planning_Docs\/Urbanization___Rural_Settlement_SSP.pdf."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ingabire, R., Nyombayire, J., Mazzei, A., Mazarati, J.B., Noben, J., Katwere, M., Parker, R., Nsanzimana, S., Wall, K.M., and Sharkey, T. (2025). Contraception Use and Pregnancy in Women Receiving a 2-Dose Ebola Vaccine in Rwanda: A retrospective analysis of UMURINZI vaccination campaign data. PLoS Med., 22.","DOI":"10.1371\/journal.pmed.1004508"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Phillips, D.E., Dieleman, J.L., Lim, S.S., and Shearer, J. (2017). Determinants of effective vaccine coverage in low and middle-income countries: A systematic review and interpretive synthesis. BMC Health Serv. Res., 17.","DOI":"10.1186\/s12913-017-2626-0"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Tagoe, E.T., Sheikh, N., Morton, A., Nonvignon, J., Sarker, A.R., Williams, L., and Megiddo, I. (2021). COVID-19 vaccination in lower-middle income countries: National stakeholder views on challenges, barriers, and potential solutions. Front. Public. Health, 9.","DOI":"10.3389\/fpubh.2021.709127"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e006951","DOI":"10.1136\/bmjgh-2021-006951","article-title":"\u2018Learn from the lessons and don\u2019t forget them\u2019: Identifying transferable lessons for COVID-19 from meningitis A, yellow fever and Ebola virus disease vaccination campaigns","volume":"6","author":"Collins","year":"2021","journal-title":"BMJ Glob. Health"},{"key":"ref_25","unstructured":"World Health Organization, Department of Immunization, and Vaccines and Biologicals (IVB) (2020). The Risk of SARS-CoV-2 Transmission to Communities and to Health Workers in LMICs Under Different Health Service Delivery Conditions. Meeting of the Advisory Committee on Immunization and Vaccines-related Implementation Research (IVIR-AC), 63\u2013116, WHO Headquarters, World Health Organization. Available online: https:\/\/terrance.who.int\/mediacentre\/data\/sage\/IVIR-AC_Pink_Book_sept_2020.pdf."},{"key":"ref_26","unstructured":"World Health Organization (2020). WHO Director-General\u2019s Opening Remarks at the Media Briefing on COVID-19\u20149 October 2020, WHO. Available online: https:\/\/www.who.int\/news-room\/speeches\/item\/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---9-october-2020."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e67023","DOI":"10.7554\/eLife.67023","article-title":"Impact of COVID-19-related disruptions to measles, meningococcal A, and yellow fever vaccination in 10 countries","volume":"10","author":"Gaythorpe","year":"2021","journal-title":"eLife"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.ijid.2022.04.005","article-title":"Impact of the SARS-CoV-2 pandemic on vaccine-preventable disease campaigns","volume":"119","author":"Ho","year":"2022","journal-title":"Int. J. Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1093\/cid\/ciz349","article-title":"Evaluating the impact of intravenous fluid resuscitation on survival for the management of patients with Ebola virus disease","volume":"70","author":"Jacob","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/S1473-3099(21)00226-7","article-title":"Ebola vaccines for mass immunisation in affected regions","volume":"22","author":"Agnandji","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"LaMori, J., Feng, X., Pericone, C.D., Mesa-Frias, M., Sogbetun, O., and Kulczycki, A. (2022). Hepatitis vaccination adherence and completion rates and factors associated with low compliance: A claims-based analysis of U.S. adults. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0264062"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Johnson, K.D., Lu, X., and Zhang, D. (2019). Adherence to hepatitis A and hepatitis B multi-dose vaccination schedules among adults in the United Kingdom: A retrospective cohort study. BMC Public. Health, 19.","DOI":"10.1186\/s12889-019-6693-5"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"5111","DOI":"10.1016\/j.vaccine.2019.05.089","article-title":"Challenges with hepatitis B vaccination of high-risk adults\u2014A pilot program","volume":"37","author":"Bridges","year":"2019","journal-title":"Vaccine"},{"key":"ref_34","first-page":"CD003941","article-title":"Patient reminder and recall interventions to improve immunization rates","volume":"1","author":"Jacobson","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s00103-019-02912-2","article-title":"Digital vaccination management systems may improve immunization rates in primary healthcare","volume":"62","author":"Schelling","year":"2019","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1186\/s12939-022-01678-5","article-title":"Vaccine equity in low and middle income countries: A systematic review and meta-analysis","volume":"21","author":"Ali","year":"2022","journal-title":"Int. J. Equity Health"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"174548","DOI":"10.1016\/j.ejphar.2021.174548","article-title":"Sex-related susceptibility in coronavirus disease 2019 (COVID-19): Proposed mechanisms","volume":"912","author":"Aksoyalp","year":"2021","journal-title":"Eur. J. Pharmacol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"101039","DOI":"10.1016\/j.ehb.2021.101039","article-title":"The impact of past pandemics on economic and gender inequalities","volume":"43","author":"Brzezinski","year":"2021","journal-title":"Econ. Hum. Biol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1007\/s11481-020-09974-z","article-title":"Is COVID-19 gender-sensitive?","volume":"16","author":"Mukherjee","year":"2021","journal-title":"J. Neuroimmune Pharmacol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e008859","DOI":"10.1136\/bmjopen-2015-008859","article-title":"Systematic review of the literature on viral persistence and sexual transmission from recovered Ebola survivors: Evidence and recommendations","volume":"6","author":"Thorson","year":"2016","journal-title":"BMJ Open"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Ioannou, G.N., Green, P., Locke, E.R., and Berry, K. (2021). Factors associated with early receipt of COVID-19 vaccination and adherence to second dose in the Veterans Affairs healthcare system. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0259696"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1146\/annurev-virology-110615-040056","article-title":"Epidemiology and management of the 2013-16 West African Ebola outbreak","volume":"3","author":"Boisen","year":"2016","journal-title":"Annu. Rev. Virol."},{"key":"ref_43","unstructured":"Centers for Disease Control and Prevention (2022, September 20). Ebola (Ebola Virus Disease), Available online: https:\/\/www.cdc.gov\/vhf\/ebola\/about.html."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"20160307","DOI":"10.1098\/rstb.2016.0307","article-title":"What we have learnt about the World Health Organization from the Ebola outbreak","volume":"372","author":"Wenham","year":"2017","journal-title":"Philos. Trans. R. Soc. Lond. B Biol. Sci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1186\/s12978-017-0430-2","article-title":"Protected to death: Systematic exclusion of pregnant women from Ebola virus disease trials","volume":"14","author":"Gomes","year":"2017","journal-title":"Reprod. Health"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e149","DOI":"10.1016\/S1473-3099(20)30194-8","article-title":"Pregnancy and breastfeeding in the context of Ebola: A systematic review","volume":"20","author":"Foeller","year":"2020","journal-title":"Lancet Infect. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.1086\/514289","article-title":"Ebola hemorrhagic fever and pregnancy","volume":"179","author":"Mupapa","year":"1999","journal-title":"J. Infect. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1186\/s13063-022-06360-3","article-title":"Safety, reactogenicity, and immunogenicity of a 2-dose Ebola vaccine regimen of Ad26.ZEBOV followed by MVA-BN-Filo in healthy adult pregnant women: Study protocol for a phase 3 open-label randomized controlled trial","volume":"23","author":"Karita","year":"2022","journal-title":"Trials"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"3899","DOI":"10.1038\/s41591-025-03932-z","article-title":"Heterologous two-dose Ebola vaccine regimen in pregnant women in Rwanda: A randomized controlled phase 3 trial","volume":"31","author":"Nyombayire","year":"2025","journal-title":"Nat. Med."},{"key":"ref_50","unstructured":"World Bank (2022, October 11). Contraceptive Prevalence, Any Method (% of Married Women Ages 15-49)\u2013Sub-Saharan Africa World Bank Website: World Bank. Available online: https:\/\/data.worldbank.org\/indicator\/SP.DYN.CONU.ZS?locations=ZG."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"97","DOI":"10.4054\/DemRes.2022.46.4","article-title":"Contraceptive use and fertility transitions: The distinctive experience of sub-Saharan Africa","volume":"46","author":"Dasgupta","year":"2022","journal-title":"Demogr. Res."},{"key":"ref_52","unstructured":"Wang, W., Staveteig, S., Winter, R., and Allen, C. (2017). Women\u2019s Marital Status, Contraceptive Use, and Unmet Need in Sub-Saharan Africa, Latin America, and the Caribbean, ICF."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/14\/7\/588\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T04:33:14Z","timestamp":1783053194000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/14\/7\/588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":52,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["vaccines14070588"],"URL":"https:\/\/doi.org\/10.3390\/vaccines14070588","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]}}}