While the United States is moving towards the vaccination of contact cases against monkeypox, France could take the same direction. Faced with cases of monkey pox, now three confirmed in France, the High Authority for Health (HAS) recommended, Tuesday, May 24, to vaccinate adults, including health professionals, who have had risky contact with a patient. .
While contamination between humans by this virus is increasing in several countries, particularly in Europe, unrelated to a trip to Africa, the HAS recommends a vaccination strategy “reactive”after exposure to a confirmed case, for “adult contacts at high risk of monkeypox”. This includes exposed healthcare professionals without personal protective measures, according to the notice made public.
This strategy “seems relevant given the incubation times of the disease and the vaccination strategy adopted in other European countries”, writes the HAS. The incubation period for monkeypox is most often between 6 and 16 days, which can range from 5 to 21 days.
Need for a more comprehensive response
This vaccination must be done with the vaccine against smallpox “of 3and generation only (in view of its tolerance profile, better than that of vaccines of 1D and 2and generations and its effectiveness)”.
Vaccines 1D and 2and generations have not been used for the general population since 1984, due to the eradication of smallpox. A vaccine of 3and generation (non-replicating live vaccine, that is to say that does not replicate in the human body), Imvanex from the Bavarian Nordic laboratory, has been authorized in Europe since July 2013 and indicated against smallpox in adults. It also has marketing authorization in the United States, under the name Jynneos, for the prevention of smallpox and monkeypox.
The HAS recommends administering this vaccine “ideally within four days after the risky contact and a maximum of fourteen days later with a two-dose regimen (or three doses in immunocompromised subjects), spaced 28 days apart”.
These recommendations are part of a more global response “including in particular the provision of antiviral treatments not evaluated by the HAS but having a marketing authorization” for monkeypox, especially for children for whom the vaccine is not authorised.
Beyond the reinforced measures for identifying and monitoring cases and vaccination in certain cases, HAS considers that, “In the current epidemic context, it is essential to adopt personal prevention and protection measures”.