This week, the World Health Organization (WHO) issued an alert about the situation of monkeypox (monkeypox) in Brazil and stated that the country’s scenario is “very worrying”. Last Saturday (23), the agency had already declared the disease a global health emergency.
Amid the high number of cases, some countries have started vaccination against the disease, it belongs to the same family (poxvirus) and genus (orthopoxvirus) as human smallpox.
, Dr. Lorena de Castro Diniz, Coordinator of the Scientific Department of Immunization of the Brazilian Association of Allergy and Immunology (ASBAI), clarified some doubts about vaccination against monkeypox and how to protect yourself.
Is there a monkeypox vaccine?
“Yes. The monkeypox vaccine was approved in 2019. Now, it is receiving approval from regulatory agencies so that larger-scale production can be started and the immunizers are distributed in countries that authorize the application.
After that, the regulatory agency of each region will determine the target audience to be vaccinated.”
What vaccines are being given against the disease?
“Currently, there are two vaccines being used to try to contain the disease, the one developed by the Sanofi laboratory. [ACAM2000] — which is now produced by Emergent BioSolutions — and by the Bavarian Nordic laboratory [MVA-BN, também chamada de Imvanex, Jynneos e Imvamune].
The first is a live virus vaccine, so it is contraindicated for the population with some immunity problem, who use immunosuppressive drugs – such as patients being treated for tumors, autoimmune diseases and living with HIV –, or who use corticosteroids for a long time. It is also not indicated for patients with extremely serious skin diseases, as the immunizing agent is applied as if it were the BCG vaccine, with a ‘stamp’ on the skin, which can lead to a worsening of the disease at the vaccine application site. .
Adverse events are usually fever, body aches, chills and, if applied inadvertently to immunosuppressed patients, can lead to disease development rather than protection.
The vaccine from the Danish Bavarian Nordic, on the other hand, is an attenuated virus, so it can also be applied to people who have immunodeficiencies. The only contraindication for this immunizer is for patients who have a severe allergy to eggs or to any of the components of the vaccine.”
How many doses are needed?
“The Emergent BioSolutions vaccine, being a live vaccine, is made in a single dose. In the Bavarian Nordic vaccine, two doses are needed to provide protection.”
In which countries are these vaccines being applied?
The application of MVA-BN has already started in Canada, the United States, some European Union countries, such as Spain, Germany, the Netherlands and Portugal, and the United Kingdom.
The regulatory agency of each country has determined the target audience to start immunization. In Canada, for example, vaccination has started for adults aged 18 and over who are at high risk of exposure.
Are there vaccines in Brazil?
Not yet. In a note to
the Ministry of Health reported that it “has been articulating with the Pan American Health Organization (PAHO) / WHO the negotiations for the acquisition of the vaccine against monkeypox, so that the National Immunization Program (PNI) can define the strategy of immunization for Brazil”.
According to the folder, the first doses of the immunizer should arrive in the country in September and the rest in November.
When they arrive, what should be the priority group?
“The entire population is vulnerable to monkeypox, but it is a disease that is not so easily contagious. The group at greatest risk, at the moment, are health professionals, who will deal with suspected cases directly.
Of course, as with any disease, people who have a more depressed immune system are more likely to catch it and develop it in a more serious way.”
According to the WHO, vaccination should also be evaluated, considering risks and benefits, for vulnerable groups, such as immunosuppressed people, children and pregnant women.
According to WHO data, the vaccine produced by the Butantan Institute in the 1970s against smallpox is up to 85% effective against the version that circulates now. Could this immunizer be applied to the population to prevent an outbreak of monkeypox?
“The smallpox vaccine that we had here until 1980 is up to 80% effective in protecting monkeys against smallpox. It would not be ideal, but in the event of a larger outbreak, it could be used in an attempt to contain .
We can use the vaccine as a prevention, but also in an immediate post-exposure to try to avoid infection, in fact, with this virus.”
the advisory of the Butantan Institute stated that the immunizer could be used in case of an outbreak, however, as smallpox was eradicated in the 1980s, this is a vaccine “with a little older technology compared to those developed from the 1990s”.
According to the Institute, the option is evaluated by Butantan’s Technical Contingency Committee of Specialists, set up on June 30 to monitor the spread of the disease. If the vaccine is approved, however, it would need to undergo a kind of “update”, due to some factors, such as the side effects it can cause.
How to protect yourself while vaccines are not yet available?
“Protection against monkeypox is done with personal hygiene, washing hands, using masks indoors, not sharing utensils such as plates, cups, cutlery, towels, clothes, and bedding should not be reused for more. of a person.
Her contagion is through droplets, direct contact with body fluids and secretions, or with skin injury. So, if the suspected case of the disease is isolated, this transmissibility is interrupted and the chance of an outbreak is much lower compared to other diseases.”
How important is vaccination against this disease? Without it, is it possible that we face a bigger outbreak?
“Like any infectious disease, vaccination is extremely important in containing outbreaks, but at this moment, we cannot go into hysteria or panic, because it is not such an uncontrolled disease, like Covid-19 or measles, for example.
It is transmissible, but not as transmissible as these others. While the vaccine is not available for the entire population, non-pharmacological care – such as distancing, wearing a mask, personal hygiene, and isolating the suspected patient – is essential to contain the outbreak of the disease.”
Cases in Brazil and in the world
Due to the growing number of cases of the disease in Brazil, the Ministry of Health set up the Emergency Operation Center (COE) this Friday (29) to monitor the epidemiological situation and prepare a vaccination plan against the disease in the country.
On the same day, the first death from monkeypox in Brazil was also recorded, according to the ministry, in the city of Uberlândia (MG). Later, Spain confirmed the first two deaths from the disease in Europe. These were the first three deaths from the monkeypox virus outside the African continent, where the disease is endemic.
The cases in Brazil, according to the latest update from the Ministry of Health, reach 1176, the majority in São Paulo and Rio de Janeiro, and another 513 suspected cases. Check the numbers by state:
In the world, according to the WHO, 19,143 cases of the disease have already been reported in 76 countries, this Friday. According to the John Hopkins University data platform, Our World in Data, on the 28th, the world already had 21,067 cases of monkeypox.
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