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Analysis: Experts don't trust the monkeypox vaccine because there isn't much information about it and there isn't enough of it

Image: Reuters Berita 24 English -  Health officials say that efforts to stop the spread of monkeypox around the world are being hampered b...


Image: Reuters

Berita 24 English -  Health officials say that efforts to stop the spread of monkeypox around the world are being hampered by the fact that vaccines are in short supply and there are questions about how best to use them. Dozens of countries are getting monkeypox for the first time.

Only 1.5 million vials of Bavarian Nordic's monkeypox vaccine have been given or are available right now in the ten countries with the most cases, which account for nearly 90% of all cases. The United States has almost all of the doses. The numbers come from a Reuters count of what governments said, and they show for the first time how big the global supply gap is.

The World Health Organization (WHO) thinks that 10 million doses will be needed to protect the people who are most at risk. Right now, the focus is on men who have sex with other men and people who come in contact with people who have HIV.

Other experts say that a fair global response would also put high-risk people in the 11 African countries where monkeypox has been a public health problem for years at the top of the list.

Several countries, like the US, UK, and SPAIN, are extending the time between doses, but no one knows what will happen.

In fact, the Bavarian Nordic shot has not been tested in humans to see if it can protect against monkeypox. However, early studies suggest that it will offer some protection.

"There are a lot of unknowns about the whole monkeypox vaccination strategy," said Dr. Dimie Ogoina, a professor of medicine at Nigeria's Niger Delta University and a member of the WHO's monkeypox emergency committee.

In 2017, Ogoina's research showed that monkeypox could be spread sexually in Nigeria, where there are no vaccines and have never been any.

"Unfortunately, I am not sure that health officials are telling the public about these doubts," he said.

Monkeypox is a virus that has already spread to more than 40,000 people this year. It spreads when people are in close contact with each other.

About 10% have been taken to the hospital because they are in so much pain, and 12 people have died. The WHO has called the outbreak a global health emergency, which is the highest level of alert.

Disease experts are worried about the heavy focus that wealthy countries have put on vaccination as the first line of defense. This is because there are signs that changing behavior, testing, and finding people who have been in contact with the disease are also important.

New monkeypox infections appear to be plateauing in Britain, Spain and Germany, a trend attributed by experts to behavioural change in at-risk groups.

"The first control strategy is behavior change," said Jay Varma, director of the Cornell Center for Pandemic Prevention and Response in the U.S. "We're asking people at high risk to do less high-risk things, like anonymous hook-ups and/or sex parties, and more low-risk things, like use condoms and check yourself and your sex partners for rashes before sex."

"This method doesn't work because it doesn't last."

Countries like the U.S., Britain, Germany, and Spain are setting up trials to see how the vaccine works, but it's not clear when the results will be available.

STRETCHING SUPPLIES

The only shot that is approved by regulators in the U.S., Europe, and other places to prevent monkeypox is made by Bavarian Nordic. It is called Jynneos, Imvanex, or Imvamune, depending on the country.

The Danish company said last week that it had hired a U.S. manufacturer to help speed up the delivery of doses.

At first, the company made one batch per week, which was between 200,000 and 300,000 doses. Since the outbreak began in May, however, production has doubled, a company representative told Reuters.

The spokesperson said that Bavarian Nordic expects its own manufacturing capacity to triple by the end of 2022 compared to what it was in May. The company is also in talks with a number of other companies to increase manufacturing capacity.

In the meantime, countries are trying to make their supplies last longer.

Britain, Canada, and Germany are only giving one dose to each person instead of two. This lets them immunize more people, even though each may get less or less long-lasting protection.

People in the U.S. and Europe are trying to get up to five doses out of a single dose of vaccine by giving it in different ways.

"You know the saying, "If you don't know where you're going, any road will take you there?" This does happen some days, "said University of Minnesota epidemiologist Michael Osterholm.

The vaccine was first made to protect against smallpox, just in case it ever comes back. But scientists are sure that it will protect against the similar monkeypox virus in at least some ways.

The regulatory approvals for Jynneos are mostly based on monkeypox experiments on animals and data showing that it is safe and makes people's immune systems work.

A WHO spokesperson said that only 40% of countries where monkeypox is spreading right now have access to the vaccine.

Brazil and Peru, two of the worst-affected countries in the world, don't have vaccines yet, but talks are going on and they should get them later this year. The WHO is trying to set up a fair way to share vaccines, but it can't because it doesn't have any.

"You can't give out doses you don't have," said Nicole Lurie, director of preparedness at the Coalition for Epidemic Preparedness Innovations (CEPI), who has been involved in the talks.

Some disease experts say that until there are more vaccines and more information about how well they work, the vaccine should be given to the most vulnerable people first, like men with weak immune systems who have sex with more than one man.

Scientists at Yale University think that less than half of high-risk men need to be vaccinated to stop the outbreak. This depends on how contagious monkeypox is, how well contact tracing works, and how well the vaccine works, all of which are unknowns.

Melanie Chitwood, a co-author of the study at the Yale School of Public Health, said, "We are really in a race against the virus."

"It's scary that there aren't enough vaccines around the world because the longer it takes to reach the critical number of people who have been vaccinated, the more time the virus has to do its job."




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