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1 Strategic Advisory Group of Experts (SAGE) on Immunization Interim Recommendations on Vaccination against Ebola Virus Disease (EVD) 7 May 2019 Over the last four weeks, the Ebola outbreak in the Eastern Provinces of the Democratic Republic of Congo (DRC) has deteriorated with a large increase in the number of cases1. A major factor in this rise is an increase in critical security incidents that have dramatically affected the ability to identify, follow up and vaccinate contacts successfully. This context challenges the implementation of ring vaccination based on the identification of contacts and contacts of contacts, as recommended by SAGE in April 2017 and confirmed by SAGE during its April 2019 meeting.2 Further, a potential vaccine shortage may manifest in case the outbreak expands further and/or is prolonged. SAGE expressed grave concern about the current worsening outbreak epidemiology and completeness of ring vaccination noting that disease transmission continues to occur nota...