@article {Robert113506, author = {Alexis Robert and Anton Camacho and W. John Edmunds and Marc Baguelin and Jean-Jacques Muyembe Tamfum and Alicia Rosello and Sakoba K{\'e}{\"\i}ta and Rosalind M. Eggo}, title = {Effect of vaccinating health care workers to control Ebola virus disease: a modelling analysis of outbreak data}, elocation-id = {113506}, year = {2018}, doi = {10.1101/113506}, publisher = {Cold Spring Harbor Laboratory}, abstract = {Background Health care workers (HCW) are at risk of infection during Ebola virus disease outbreaks and therefore may be targeted for vaccination before or during outbreaks. The effect of these strategies depends on the role of HCW in transmission which is understudied.Methods To evaluate the effect of HCW-targeted or community vaccination strategies, we used a transmission model to explore the relative contribution of HCW and the community to transmission. We calibrated the model to data from multiple Ebola outbreaks. We quantified the impact of ahead-of-time HCW-targeted strategies, and reactive HCW and community vaccination.Results We found that for some outbreaks (we call {\textquotedblleft}type 1{\textquotedblright}) HCW amplified transmission both to other HCW and the community, and in these outbreaks prophylactic vaccination of HCW decreased outbreak size. Reactive vaccination strategies had little effect because type 1 outbreaks ended quickly. However, in outbreaks with longer time courses ({\textquotedblleft}type 2 outbreaks{\textquotedblright}), reactive community vaccination decreased the number of cases, with or without prophylactic HCW-targeted vaccination. For both outbreak types, we found that ahead-of-time HCW-targeted strategies had an impact at coverage of 30\%.Conclusions The optimal vaccine strategy depends on the dynamics of the outbreak and the impact of other interventions on transmission. Although we will not know the characteristics of a new outbreak, ahead-of-time HCW-targeted vaccination can decrease the total outbreak size, even at low vaccine coverage.summary Targeting health care workers for Ebola virus disease vaccination can decrease the size of outbreaks, and the number of health care workers infected. The impact of these strategies decrease depends on timing, coverage, and the dynamics of the outbreak.}, URL = {https://www.biorxiv.org/content/early/2018/11/23/113506}, eprint = {https://www.biorxiv.org/content/early/2018/11/23/113506.full.pdf}, journal = {bioRxiv} }