Role of vaccines in the monkeypox outbreak

The Director-General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesusdecided on July 23 to classify the stream Outbreak of monkeypox as a Public health emergency of international concern. A decision taken after the International Health Regulations Emergency Committee failed to reach an agreement at its second meeting. A step justified as an opportunity to predict, control and stop the spread of monkeypox.

On July 22, the European Medicines Agency (EMA, for its English acronym) recommended expanding the indication for the Imvanex vaccine, developed against smallpox, for the prevention of monkeypox in adults. In the case of Spain, one of the hardest hit countries, on July 12 the Public Health Commission recommended the Pre-exposure prophylaxis in people who engage in risky practices and who nurture Post-exposure prophylaxis cases confirmed by close contacts, particularly in groups that may be at higher risk.

Although the WHO believes that the Mass vaccination against monkeypox is not required, it takes into account that the Post-Exposure Vaccine It is a crucial element in stopping the spread of the monkeypox outbreak. But a strategy based solely on vaccines is not the way to go.

Usually, monkeypox is one self-limiting disease There is no danger to life for healthy people. It is an endemic disease in some regions of the African continent, where fatalities have occasionally been reported. A total of five have been registered so far this year. Currently, the WHO European Region is hardest hit by the current outbreak.

“Beyond the social and sexual networks of men having sex with men, it is clear that cases are increasing in other populations, including vulnerable groups such as women and children, although they remain minimal. That Sexual transmission through close contact is the main route of transmission, but cases are discovered through episodes of transmission to the house and sometimes with no clear history of exposure,” WHO Regional Director for Europe, Dr. Hans Henri P. Kluge.

“Case reports may be atypical and therefore alert to the possibility of monkeypox in any patient and not just men who have sex with men or patients who have traveled to areas where cases of monkeypox have been reported.

This situation makes the vaccination alone is not enough to contain the spread of the outbreak. “While we acknowledge the uncertainty of how this outbreak will evolve, we must respond to the epidemiology ahead by focusing on the predominant mode of transmission (skin-to-skin contact during sexual encounters) and the groups at greatest risk of infection focus.” indicates that the path to be followed requires it “Common and Shared Responsibility”between healthcare institutions and authorities, governments, communities and affected individuals.

Based on this, for those currently at increased risk of infection, men who have sex with men, and those with multiple sexual partners, he has recommended the following:

  • Learn about all the mechanisms by which the disease spreads and what you can do to protect yourself.
  • Consider limiting your partners and sexual interactions at this time.
  • Although the vaccination may be available for some people at higher risk of exposure, this is not a solution, so he calls for all necessary measures to be taken to reduce the risks.
  • If a person thinks they may be infected, they should do everything possible to prevent the disease from spreading.

Healthcare systems and healthcare providers are encouraged to do so by the WHO Regional Office for Europe Eliminate all barriers This can make it difficult to access tests, medical care or vaccinations. “Any barrier, no matter how big or small, will prevent patients from receiving the care they need.” With that in mind, they emphasize the urgent need “Remove any judgment or stigma”and recalls that the lessons that HIV and AIDS have taught us in this regard must not be forgotten.

“Countries must adhere to the principles of equity and help ensure vaccines and antivirals reach those who need them most, rather than stockpiling and developing policies that only harm the common good, as we saw in responding to have Covid19″

It is also prompted to do so health specialists to increase their awareness and become aware of what the disease looks like and what symptoms it shows. “Case reports may be atypical and therefore alert to the possibility of monkeypox in each patient and patient not just in men who have sex with other men or in patients who have traveled to areas where cases of monkeypox have already been reported.”

One of the key points in the strategy to end the monkeypox outbreak comes from public health authorities. Together with the health ministries, they must develop the national capacities for Monitoring, investigation, diagnosis and contact tracingsince many of the cases are likely to go unnoticed.

“They need to work with other risk groups and communities to develop and disseminate messages to reduce transmission and encourage uptake of health services. Urgently find ways to address the realities of this outbreak and ensure the response is focused on stopping transmission in the groups and settings where it is occurring or likely to occur.”

The WHO Regional Director for Europe reminds that the need is great cross-regional cooperation based on the political will to “generate evidence to support the use of vaccines and antivirals”.

“Countries must adhere to the principles of justice and contribute to it Ensure vaccines and antivirals reach those who need them mostinstead of hoarding supplies and devising policies that only harm the common good more generally, as we have seen in the Covid-19 response,” he concludes.

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