The Health Emergency Response Authority (HERA) is coordinating the procurement of monkeypox vaccines and therapeutics on behalf of EU member states as the virus continues to spread outside of endemic countries.
As cases of monkeypox continue to emerge throughout the EU, HERA is leading talks on vaccines and therapeutics against the zoonotic disease.
“It was a broad consensus reached with the member states for HERA to coordinate actions on their behalf in this context and to procure the medical countermeasures as soon as possible,” said the Commission’s spokesperson on Friday (10 June).
Germany already ordered 240,000 vaccines at the end of May. “40,000 units will be delivered during the first two weeks of June, and 200,000 more after that,” health minister Karl Lauterbach said on public TV on Sunday (29 May).
Vaccines used against monkeypox are developed to fight smallpox – a virus from the same family as monkeypox.
“There is a stockpile of vaccines against smallpox. This time, we don’t have smallpox, it’s monkeypox, but it’s the same family of viruses. We know that the vaccine for smallpox can be used for monkeypox with a high level of efficacy,” said Sylvie Briand, the World Health Organisation’s (WHO) global infectious hazard preparedness department’s director, during a press briefing on Wednesday (8 June).
She added that WHO is looking at how many vaccine doses are available globally as the exact number is unknown, and the Commission has not provided any data.
Vaccines will not be used for mass vaccination but rather for certain groups, as the virus spreads through close skin-to-skin contact.
“Vaccination will be limited to very specific cases as the transmissibility of the risk from the virus is not comparable, for instance, to the risks that we know in the context of COVID,” the Commission’s spokesperson said.
As Tedros Adhanom Ghebreyesus, WHO’s director-general, advised, some countries might consider “post-exposure vaccination, ideally within four days of exposure […] for higher risk close contacts, such as sexual partners, family members in the same household and health workers”.
Cases grow outside endemic countries
The vaccination topic becomes even more crucial as the risk of monkeypox becoming established in non-endemic countries, as Tedros warned, “is real”.
In the EU and EEA countries, the number of cases reached over 700, the European Centre for Disease Prevention and Control (ECDC) reported on Thursday (9 June).
Europe is currently home to the majority of cases outside endemic countries in Africa. Spain and Portugal reported the most issues, each with nearly 200 confirmed, followed by Germany with over 110.
As of Wednesday (8 June), 29 countries that are not endemic reported over 1000 cases of monkeypox. The cases are mild, and no deaths have been reported so far. Most cases are still seen among men who have sex with men, but several countries are seeing cases among women as well.
Why is it spreading now?
While monkeypox has been present in some African countries for five decades, the spread outside the endemic areas has not been seen until now. The reason for this mysterious spread is being investigated, but it is not clear if the numbers being seen are just the tip of the iceberg.
“The sudden and unexpected appearance of monkeypox in several non-endemic countries suggests that there might have been undetected transmission for some time. How long? We don’t know,” Tedros said.
There are two strains of monkeypox, and the one seen spreading across the world is a milder one. But the coin has two sides: while people in most cases do not need medical assistance, on the other side, they are more likely to continue socialising and potentially spreading the virus.
“It’s easier to move out and about if you’re not feeling that ill. So it’s possible that transmission is being increased through increased human contact,” said Rosamund Lewis, head of the WHO smallpox secretariat, explaining why there might be an increase in cases.
It is also being looked at if mutations could emerge, but as it is a DNA virus, the mutations are less likely to occur, especially when compared to RNA viruses, such as the COVID-19 virus.
Commenting on rising numbers, Ibrahima Socé Fall, assistant director-general for emergency response at WHO, mentioned climate change, deforestation, agriculture and “more contact between human population and the forest” are some of the factors that influence the rise in disease such as monkeypox, ebola and others.
He added that increased travelling opens ways for further spread.
“Most of the time, we don’t invest enough into early detection and rapid containment. So if you don’t do that, and if you don’t control the disease at the source, we can continue rushing when developed countries are affected, but we will never end the problem,” he said.
[Edited by Alice Taylor]