After almost a week of preparations and coordination within the European Union (EU), the Ministry of Health announced this Wednesday the centralized purchase, together with the other member states, of vaccines and antivirals to deal with the current outbreak of monkeypox suffered by twenty countries in the world, as explained by Minister Carolina Darias.
The purchase was agreed this morning in Brussels and the European Commission will channel it through the Health Emergency Preparedness and Response Authority (HERA), created in response to the coronavirus pandemic to deal with potential health threats.
Darias, who made the announcement after the meeting of the Interterritorial Health Council, has not specified the number of doses that would correspond to Spain or the days it will take to arrive, although health sources put them at “several thousand.” “It is a vaccine of limited production and it is up to HERA to make the appropriate decisions,” explained the minister. Spain, which after the United Kingdom is the second most affected country, today has added eight new positive cases to reach 59, according to the PCR tests carried out by the National Center for Microbiology. In total, nearly 200 cases have been diagnosed in twenty countries around the world in what is the largest outbreak ever recorded outside the endemic areas of the African continent.
The decision to buy vaccines, which advanced last week EL PAÍS, It comes after other countries such as the United Kingdom and Germany, which announced on Tuesday the acquisition of 40,000 doses, have taken the same step in recent days and that communities such as Madrid have urged the Ministry to take the step. In addition to vaccines, Health is also preparing to purchase Tecovirimat antiviral treatments to treat patients at higher risk. All cases diagnosed in Spain so far have had a mild evolution.
The vaccine to be purchased is Imvanex, manufactured by the Danish laboratory Bavarian Nordic (the only manufacturer). Actually, the vaccine is not authorized by the European Medicines Agency (EMA) against monkeypox, but against traditional smallpox. Both viruses, however, are similar and the immune response developed against one also confers protection against the other in more than 85% of cases. In the United States, where this drug is marketed under the brand name Jynneos, the authorization is for both types of smallpox.
The fact that Spain acquires the vaccines does not necessarily mean that it will use them, but rather it is a step to be prepared for a possible increase in cases or future outbreaks. The decision to start using it must be made by the Public Health Commission in accordance with the recommendations of the experts from the Vaccine Conference, which plans to discuss it at a meeting scheduled for the next few days. In separate meetings held this week, the two bodies have already discussed it, although they have not yet made a decision.
“The vaccine can be a useful tool. Its use will not be generalized in any case, but to avoid infection in close contacts of those infected whose health may be at risk. Perhaps also for health personnel with a higher risk of exposure. In any case, the current measures to control the outbreak, such as early identification of cases, isolation of patients, and contact tracing and surveillance, are having an effect in controlling the outbreak. But the vaccine will be one more asset that we will have if necessary, ”explain health sources.
The use of the smallpox vaccine in an outbreak is carried out following a so-called “ring” strategy, in which the risk contacts of the people who test positive are successively vaccinated until the chains of contagion are stopped. The administration should preferably be done in the first four days after exposure to the virus, since if it is done later it is not possible to avoid contagion, although the symptoms are milder.
The reason why the immune response achieved against the vaccine is faster than the natural one against the virus itself, and therefore allows to anticipate for the purposes of infection and prevention, it is because the injection skips one of the phases that the virus follows in the body. After being contagious between two people, the pathogen first reaches the respiratory tract, where it replicates during the first days (normally three to five). Subsequently, the virus passes to the lymph nodes and three or four days later it passes to the blood. With the vaccine, the process starts directly in the lymph nodes, so when the virus reaches the blood after natural infection, it finds an immune system already prepared to deal with it.
Spain already has a strategic reserve of nearly two million vaccines for traditional smallpox, whose use was planned in the event of a resurgence of the disease, eradicated four decades ago, or its use in biological weapons. These doses, however, are of an earlier version, of the so-called second generation and with many more side effects, and their use is not currently authorized in Europe.
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