Still no panic in the face of a disease at risk of contagion ” very weak “, but still a safety recommendation. Tuesday, May 24, the French High Authority for Health issued its opinion on monkeypox and recommends vaccinating people who have been in contact with the sick.
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In France, three cases have so far been confirmed. The virus is spreading rapidly in the UK, with more than 50 infections since early May. Nearly twenty countries where this smallpox is normally absent have already reported patients. No case is serious and no death is to be deplored for the moment. In countries where monkeypox is endemic, in West and Central Africa, the rare serious forms mainly affect children.
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Causing fever, muscle aches, swollen glands and a rash on the hands, feet and face, this condition usually clears up on its own within a few weeks. If there is no treatment or targeted vaccine, the “classic” smallpox vaccine is 85% effective against this disease according to the Pasteur Institute. It is this vaccine that the HAS now recommends for contact cases, “in post-exposure”.
Use a “third generation” vaccine
This vaccine would be administered “within 4 days after the risky contact and a maximum of 14 days later, with a two-dose regimen (or three doses in immunocompromised subjects), spaced 28 days apart”. The HAS claims to use “only the third generation vaccine”known under the trade name of Imvanex in Europe and Jynneos in the United States.
Like the first vaccines, this product does not contain the very dangerous smallpox virus, but a related virus, vaccinia. But unlike these first generations, the new formulas use an attenuated form of the vaccinia virus, which therefore causes fewer reactions.
“The first and second generation vaccines required a particular injection technique (by bifurcated needle), and presented reactogenicity and serious adverse effects”, recognizes the HAS which does not wish to use them. The third generation product remains reserved for adults, and should not be used in pregnant women. This smallpox vaccine was authorized in 2013 in Europe, but only for exceptional uses.
With the complete eradication of smallpox in the 1970s, data on the effectiveness of this product is lacking, especially regarding the prevention of transmission of the virus. Trials also need to be conducted on the effectiveness of a booster dose in people who were vaccinated against smallpox in childhood. Finally, the HAS calls for research into the mode of transmission of monkeypox to be carried out quickly.