Background <p>Outbreaks of high-threat zoonotic diseases like Ebola virus disease (EVD) occur more frequently, causing severe health and socioeconomic impacts. With an average case fatality rate of 67%, EVD outcomes can significantly improve when timely care and vaccination are provided. Despite the WHO’s prequalification of EVD vaccines (Ervebo and Zabdeno/Mvabea), their long-term access and use remain uncertain, with 40% of the global stockpile volume expired in 2024. With the launch of a new preventive vaccination program, understanding the evolving EVD immunization system to inform effective vaccination strategies is critical. However, such a review is lacking to date.</p> Methods <p>This scoping review mapped the literature on WHO-prequalified EVD vaccines post-licensure. Following the PRISMA-ScR guidelines, English articles from two databases (PubMed and African Index Medicus) published from January 1, 2020, to October 23, 2023, were included. Studies focusing solely on non-EBOV species or pre-licensure evidence were excluded. Two reviewers screened records independently via Rayyan, and extracted data with an inductive template, synthesizing content through thematic analysis and critical interpretive synthesis.</p> Results <p>A total of 100 articles were included, resulting in a framework of 8 thematic components and 25 subcomponents characterizing the EVD post-licensure immunization system. Interdependencies and uncertainties within components create multiple viable vaccination strategies, but also delay decision-making. Most articles (<i>n</i> = 80) described EVD vaccine-specific components, particularly clinical performance (<i>n</i> = 38). The literature does not specifically address topics regarding workforce, financing or One Health, which were considered in other frameworks. Moreover, evidence regarding the effectiveness and perceptions of strategies beyond use during outbreaks remains limited. While health system components are discussed, they are not yet integrated into vaccine-specific guidelines or models. These gaps present a need for system-wide, participatory research to support context-specific and effective vaccination strategies.</p> Conclusions <p>This review contributes to the literature with a comprehensive framework of the EVD immunization system, synthesizing elements that shape effective vaccination strategies. Given ongoing vaccine development for other high-threat and sporadic diseases, insights from EVD vaccines offer opportunities to design effective immunization systems to better protect populations at risk and strengthen health systems.</p> Registration <p>The protocol was registered prospectively in the Open Science Framework (DOI: 10.17605/osf.io/f6tua).</p>