You wouldn’t need to vaccinate all of those people. I’m sure vaccination would be offered after a risk assessment, just as rabies vaccine/prophylaxis is offered now. So, not everyone in the apartment building would be offered vaccine, but Mr. Duncan’s family would receive it.
I will interject that it has now been 12 days since anyone was potentially exposed to Mr. Duncan, and no one has become ill. That’s good, since the average incubation is around 7 or 8 days. In 9 more days, his contacts are all officially out of danger.
The big problem with Ebola vaccines and drugs is that we cannot test them using the normal clinical trial protocols. No one is going to volunteer to be exposed to Ebola to see if the vaccine works, and there is no way such a trial can contain a placebo arm. Drugs can be tested on actual Ebola patients, but then there is an ethical problem with including a placebo arm to the trial.
I can't emphasize enough how encouraging your response was. My analysis from the middle of August has been that only vaccination (in addition to effective anti-viral treatment) can end this outbreak once Ebola becomes endemic in West Africa, and that the latter is inevitable.
Your reminder about how real-world vaccination campaigns against existing, but not yet truly widespread, epidemic outbreaks are implemented led me to finally understand how Ebola can be snuffed out here without mass quarantines. I feel much more confident about the future.
Thank you very much.