The United States offers vaccines to some people exposed to monkeypox. Here’s what you need to know

The United States offers vaccines to some people exposed to monkeypox.  Here's what you need to know
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Monkeypox vaccines are now available for some health workers treating infected people.

“I am happy to report that even with the first case in Boston at Massachusetts General Hospital, our government colleagues were able to get vaccines to that hospital. And just yesterday they have already started offering the vaccines. to healthcare workers who have been exposed,” Dr. Raj Panjabi, who leads the White House’s response to monkeypox, told CNN’s Laura Coates Monday night.

“The first part is to identify infected people, isolate them and make sure they get the care they need,” Panjabi said. “The second part is to make sure that we vaccinate those who have been exposed to infected people. If we do that over and over again – and that’s our approach in the White House and across government – then we have a better chance of ending this epidemic.”

A senior Biden administration official said Tuesday that typically small groups of people who have been exposed to a monkeypox patient with symptoms could be offered the vaccination — but that’s not a a mass vaccination effort.

In the USA, Jynnéos vaccineadministered in two doses four weeks apart, is allowed to prevent smallpox and monkeypox in adults.

“Because the monkeypox virus is closely related to the virus that causes smallpox, the smallpox vaccine may protect people against monkeypox,” says the US Centers for Disease Control and Prevention website. United. “The smallpox and monkeypox vaccines are effective in protecting people against monkeypox when given before exposure to monkeypox. Experts also believe that vaccination after exposure to monkeypox may help prevent illness or make it less serious.”

Scientists have known for years that smallpox vaccines can also be effective in preventing monkeypox. The pox virus that causes smallpox and the monkeypox virus belong to the same family.

“The viruses come from the same family of viruses, and what we’ve seen in previous outbreaks of monkeypox is that vaccinating contacts aborts infection or attenuates infection in people with monkeypox” , said Dr. Amesh Adalja, principal investigator at Johns Hopkins. Bloomberg School of Public Health Center for Health Security.

But don’t expect large-scale deployment of vaccines.

“I think we will have to use vaccines in contacts of cases. It’s not something where everyone is queuing up and getting vaccinated,” Adalja said of the current outbreak. “That’s going to be key to stopping the cases.”

What vaccines might work against monkeypox?

The senior administration official said Tuesday that there are enough vaccines to cover the current level of cases in the United States.

“Right now we have over 1,000 doses of [Jynneos] available, and we expect that level to increase very rapidly in the coming weeks as society provides us with more doses,” said Dr. Jennifer McQuiston, deputy director of the Division of High Consequence Pathogens and of pathology at the National Center for Emerging and Zoonotic Infectious Diseases, said Monday.

The CDC estimates that the vaccine is at least 85% effective in preventing monkeypoxbased on African data.

Another vaccine, called ACAM2000, is licensed in the United States to prevent smallpox. Although the vaccine can be used to prevent monkeypox, it is not licensed for this.

The United States has more than 100 million doses of ACAM2000, McQuiston said.

“ACAM2000 is an older generation smallpox vaccine that has significant potential side effects,” she said. “So a decision to use this on a large scale should have serious discussion behind it.”

ACAM2000 is a live virus vaccine – and once the vaccine is given, a lesion will develop at this site. Because the virus grows at the site of injury, it can spread to other parts of the body or even other people, according to the CDC, which is why people who receive ACAM2000 “should take precautions” to prevent the spread.

In comparison, the Jynneos vaccine is given as a live virus that does not replicate. This means there is no visible “catch” and, therefore, no risk of viral spread, according to the CDC. Some Commons vaccine side effects include pain at the injection site, muscle pain, headache, or fatigue.

Who should get vaccinated against monkeypox?

Most people will not be vaccinated against monkeypox. It is based on direct exposure.

the The CDC’s Immunization Advisory and Practices Committee voted last year to recommend vaccination for certain groups at risk of monkeypox and other related viruses because of their occupations. This could include staff in research laboratories and healthcare workers, for example, who treat infected people.

Amid the global outbreak, World Health Organization officials plan to make recommendations on who should be given a smallpox vaccination to reduce their risk of monkeypox.

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“We will make recommendations on who should be prioritized for this,” said Maria Van Kerkhove, emerging diseases and zoonoses manager and WHO technical lead on Covid-19, during a questions/answers on social networks Monday.

“It’s not something everyone needs. It’s a virus that spreads between people who come into close contact with those who have cases,” Van Kerkhove said. “We really need to discuss the factual use of these measures, access and equity.”

Andy Seale, strategy adviser for the Department of Global Programs on HIV, Hepatitis and STIs at WHO, added that vaccinations should be considered for countries where monkeypox is endemic, which are in West and Central Africa.

“Communities are already telling us, ‘if we get this right, if we contain this, if we get the right of access for the epidemic, we have to do this for endemic countries as well,'” Seale said.

Can someone get vaccinated after being exposed to monkeypox?

Vaccination after exposure to monkeypox virus may still offer some protection, According to the CDC.

“That’s the norm. We usually don’t vaccinate everyone beforehand. We use vaccination as post-exposure prophylaxis,” Adalja said.

“Because monkeypox has a long incubation period, just like smallpox – it’s about 12 days, on average, for monkeypox – you can intervene with a vaccine in an exposed person, and that will abort the infection” , did he declare. “Or if you get an infection, maybe it gets to them very late or late in the incubation period, that makes the infection less severe.”

But the sooner an exposed person receives the vaccine, the better. The CDC recommends administering the vaccine within four days of exposure to prevent illness. If given between four and 14 days of exposure, vaccination can reduce symptoms but cannot prevent the disease itself.

Overall, people who have been exposed to monkeypox virus and have not been vaccinated in the past three years should consider getting vaccinated, according to the CDC.

Will a smallpox vaccination protect against monkeypox?

There is likely a “remnant” of monkeypox protection for adults who were vaccinated against smallpox as children, Adalja said, but it may not be complete protection.

“The smallpox vaccination program ended in the 1970s in the United States. Obviously, if someone is in the United States military and was vaccinated last year, I’m sure that ‘He’s completely protected,” Adalja said. “But people who were vaccinated as children back when smallpox was a routine childhood vaccination, they may have residual immunity.”

The top Biden administration official said on Tuesday that, theoretically, there is some protection offered by a previous smallpox vaccination, but there is not good evidence on how much protection – and that protection could wane. with time.

Has the monkeypox virus changed with this epidemic?

The official said it does not appear that anything has changed in the biology of the monkeypox virus and the chances of contracting it are still very low for the general public.

WHO officials found no evidence of monkeypox virus change or mutation in this outbreak. Therefore, there is no evidence to suggest licensed vaccines will not work against the currently circulating virus.

“It’s a very stable virus. So we don’t have evidence yet that there’s a mutation in the virus itself,” said Rosamund Lewis, head of the smallpox secretariat at the Emergency Program. WHO, during Monday’s question-and-answer session.

“We’re starting to collect that information,” Lewis added. “We will bring together our groups of virologists and other experts who will discuss this same question based on the genome sequence of some of the detected cases.”

It’s a “key question” that needs to be answered, said Dr. Daniel Rhoads, co-chair of the microbiology committee of the College of American Pathologists.

“Has something changed with the biology, or is it just an unusual situation that hasn’t happened before or that we haven’t recognized before? I think whenever there’s a shift in geography for these endemic diseases, that’s a key question,” said Rhoads, a pathologist at the Cleveland Clinic in Ohio.

“Every time we see a new infection or an infection transmitted in a way that seems to be new, I always wonder, is this just something we haven’t recognized before that has always been there? Or is it is this a true biological change, which would be due to a mutation of the virus? I don’t know,” Rhoads said.

“I guess once they sequence the virus that’s causing the current outbreak, they can compare it to known sequences, and then hopefully we’ll have some idea of ​​whether it’s or no of the same old monkeypox or if there is something that seems to be different.”

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