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Structural vaccination against mpox is important, says professor of skin infections: ‘Spread can happen very quickly’

According to experts, it is a good idea to set up a limited vaccination program against the mpox virus. Now that there are worldwide warnings about a new outbreak of a more dangerous variant, the importance of this is also increasing.

The United Nations World Health Organization (WHO) has declared the outbreak of the mpox virus, formerly monkeypox virus, an international health risk. This is because there is an outbreak of a new variant of the virus, which is more pathogenic and also more deadly.

More dangerous variant

Professor of skin infections and dermatologist Henry de Vries of the Amsterdam UMC and the GGD Amsterdam shares the concerns of the WHO. “It is a more dangerous variant than in 2022.” In Africa, more than 500 deaths from the virus infection have now been reported, children and pregnant women have the highest risk of death there. It spreads there mainly through small children, because they play with animals that carry the virus.

According to the professor, it is good that the WHO has given the advice. “It ensures that people are more alert, that there is cooperation and that measures are taken where necessary, such as vaccination or isolation. The vaccines will then also become more easily available in Africa, which is also in our own interest.”

Mpox outbreak in the Netherlands

The old variant of the mpox virus also emerged in the Netherlands 2 years ago. The main symptom of the viral infection is a rash in the form of red spots, bumps or blisters. The virus can be transmitted via skin, mucus and sexual contact. Mainly homosexual men were infected at that time.

That was the reason to launch a vaccination campaign for specific risk groups. According to De Vries, there is currently no acute threat, because there are now few to no more cases of infection in the Netherlands. “This only concerns the earlier variant that was also circulating in 2022. In all cases, these were infections that were contracted abroad, such as in Southern Europe during holidays.”

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Mpox of apenpokken?

During the previous outbreak in the spring and summer of 2022, the disease was known as ‘monkeypox’. A few months later, the World Health Organization (WHO) decided to officially rename the disease to ‘mpox’. This was because the old term was experienced by some groups as stigmatizing and discriminatory.

New vaccination program

However, according to the professor, it could be useful to restart this program with the new threat. “In today’s globalized world, things can go quickly. It only takes one traveler, who has a lot of contacts.” According to De Vries, the current smallpox vaccines should also work against the new variant.

Last year, at the request of the Ministry of Health, Welfare and Sport, the Health Council also advised to continue the vaccination program for people with changing sexual contacts.

New variant cannot be ruled out

De Vries is therefore an advocate of this. “The advice was to continue offering the vaccine on a low flame. That involves thousands of vaccines per year. It is much better to let that continue instead of not having a clear vaccination program,” he emphasizes.

In response to questions from EenVandaag, the Health Council today stated that the current outbreak supports the need for vaccinations. “The virus variant that circulated outside Africa in 2022 and 2023 is associated with relatively mild symptoms.” But according to the Council, it cannot be ruled out that a more contagious variant will also reach Europe, or that the circulating virus will become more contagious.

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Low disease burden due to vaccination

In that case, the disease burden would be higher than has been seen so far, the response reads. “All things considered, the committee believes this provides sufficient reason to consider vaccination against mpox for men who have sex with men with the highest sexual activity.”

According to the Health Council, offering this vaccination also has additional benefits. “The vaccination keeps the disease burden as low as possible and can contribute to the elimination of mpox outside Africa.” The committee expects that it is more efficient to set up a structural program now, rather than only starting when a new outbreak occurs.

No additional measures yet

The Netherlands will not be taking any additional measures for the time being in response to the WHO emergency. This is because the risk is very small, a spokesperson for the Ministry of Health, Welfare and Sport said. We still have the smallpox vaccine in stock and Minister Fleur Agema will investigate whether the African countries with an mpox outbreak can be helped with it.

State Secretary Maarten van Ooijen informed the Lower House in May that he would leave a decision on the advice for a structural vaccination program to the new cabinet. It is not known when more will be known about this.

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New outbreak of mpox: experts call for structural vaccination program

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