Blocked monkeypox vaccines increase risk of spillover and wider outbreak

There are growing fears that a monkeypox vaccination campaign could be stalled due to a supply shortage.

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Concerns are growing that the window of opportunity to contain the escalating monkeypox outbreak could be closing, with vaccine shortages leaving some at-risk groups waiting weeks to get bitten.

Health professionals have warned that a failure to bring the outbreak under control could see it spread to other populations or species.

The UK Health Security Agency has said it expects to run out of its initial batch of 50,000 vaccines over the next two weeks and may not receive further doses until September. Meanwhile, other high-case countries are considering new inoculation methods amid dwindling supplies.

Bavarian Nordic – the sole supplier of the only approved monkeypox vaccine – announced on Thursday that it had signed an agreement with contract manufacturer Grand River Aseptic Manufacturing to help complete orders for its Jynneos vaccine in the United States while freeing up capacity for other countries. The process should take about three months to be operational.

This follows reports on Wednesday that the Danish pharmaceutical company was no longer sure it could meet growing demand, according to Bloomberg.

More than 35,000 cases of monkeypox have so far been confirmed in 92 non-endemic countries since the first was reported in the UK on May 6. Twelve were fatal.

Cases increase by 20% in a week

The World Health Organization warned on Wednesday that the spread of the virus continues apace, with cases rising 20% ​​in the past week alone.

Although anyone can be infected with monkeypox, the vast majority of cases so far have been confirmed in gay and bisexual men who have sex with men.

This has sparked an inoculation campaign, particularly in advanced economies, aimed at protecting the most vulnerable with pre- or post-exposure vaccinations. However, vaccine supply shortages and delayed rollouts are increasing the risks of a wider outbreak, infectious disease specialists say.

If an outbreak needs to be stopped, you have a very short window of opportunity. At this point, we see that window of opportunity slowly closing.

Professor Eyal Lesham

infectious disease specialist, Sheba Medical Center

“We know from past outbreaks that if an outbreak needs to be stopped, you have a very short window of opportunity. At this point, we see that window of opportunity slowly closing,” the professor told CNBC on Thursday. Eyal Leshem of the Sheba Medical Center in Israel.

That, in turn, could see the virus spread more easily to other groups or start behaving in different ways, Leshem said.

“As we see more cases, the chances of containing this disease are reduced. We can see spillovers from the current at-risk population to other populations,” he said, pointing to close contacts and household members, including children and pets, as potentially vulnerable groups. .

The first known case in this outbreak of an animal catching monkeypox in humans was reported earlier this week in Paris.

Vaccines “not a miracle solution”

As countries wait for new vaccine supplies, some are now trying other ways to protect vulnerable groups.

In a leaked letter to the BBC, the UKHSA said it would withhold some of the remaining stock just for post-exposure patients, meaning others seeking preventative care would have to wait.

Elsewhere, Spain – which has the most reported cases from a non-endemic country after the United States – last week sought permission from the European Medicines Agency to give people smaller doses of the vaccine in the aim to distribute limited supplies more widely.

It follows similar dose-saving plans backed by US health regulators, which allow one vial of vaccine to deliver up to five separate injections by injecting between the skin rather than under it.

A relatively short and temporary decrease in the rate of vaccine delivery may not have a big impact.

Dr. Jake Dunning

senior researcher, University of Oxford

Still, the WHO technical lead for monkeypox, Dr Rosamund Lewis, said Wednesday that vaccines should not be seen as the only form of protection against the virus.

“Vaccines are not a silver bullet,” she said, noting that more data on their effectiveness is still needed. The current data comes from a small study from the 1980s, which found that smallpox vaccines are 85% effective in preventing monkeypox.

She recommended those who believe they are at risk to consider “reducing their number of sexual partners [and] avoiding group sex or casual sex. If and when someone receives a vaccine, they should also wait until they have time to mount the peak immune response before engaging in sex, usually two weeks, she added.

Dr Jake Dunning, a senior researcher at the University of Oxford’s Pandemic Sciences Institute, agreed, noting that a brief drop in vaccinations would not necessarily derail broader efforts to control the virus.

“If it turns out that in fact a large proportion of those most at risk of exposure have already been vaccinated, a relatively short and temporary decrease in the rate of vaccine administration may not have a large impact on achievement of the headline goal,” he said. .

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