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Monkey pox: France refines its strategy

Paris, Friday August 5, 2022 – France will modify its vaccination policy against monkey pox. In the United States, the fight against the epidemic is intensifying. The monkeypox epidemic continues to progress in France.

According to the latest report from Public Health France published on Tuesday, our country has 2,239 confirmed cases of the disease, including 50% in Ile-de-France. 99% of those infected are adult men and 96% of those whose sexual orientation is known are men who have sex with men (MSM).

72% of them declare having had at least two sexual partners in the 3 weeks preceding the onset of symptoms. Only 3% of patients required hospitalization and no deaths were reported. The number of confirmed cases has more than doubled in three weeks.

The time between the two doses of vaccine lengthened

The main tool in the fight against the spread of the epidemic remains for the moment vaccination, which is reserved for homosexual men and multi-partner transsexuals, a population estimated (roughly) at around 250,000 people by the High Authority for Health (HAS).

According to the Ministry of Health, 136 vaccination centers have been opened in France. A specific monkeypox vaccinodrome has been opened in Paris and another should soon be in Marseilles. In total, 18,500 people have already been vaccinated and 42,000 doses have been destocked.

On the other hand, the government still refuses to indicate how many doses of smallpox vaccines are available, on the grounds that this number would be protected by defense secrecy, arousing strong criticism from the left-wing opposition and LGBT associations.

In its first opinions on monkeypox of May 20 and June 20, the HAS recommended that vaccination be done with two doses (only one for people already vaccinated against smallpox born before 1979, three for immunocompromised) spaced of 28 days.

However, the Ministry of Health decided this Thursday, after prior advice from the HAS, to extend the duration between the 1st and 2nd dose. Thus, with the exception of immunocompromised people and those who already benefit from a second appointment, first-time recipients will have to wait before obtaining a second dose.

The unspoken words of the Ministry of Health

To justify this policy change, the Ministry of Health indicates that the priority is to “guarantee the greatest number of people at risk access to vaccination in the shortest possible time” and “the time required after the administration of the doses of the vaccine to obtain an optimal level of protection is to date poorly known”.

Studies on the effectiveness of vaccination against monkeypox in real life will therefore be carried out in order to be able to establish a new vaccination schedule next September. On the other hand, the ministry refutes any “tension of supply of vaccines”.

Believing that “the effectiveness of the vaccine after one or two doses will never be 100%”the General Directorate of Health (DGS) also insists on other prevention and risk reduction measures such as the isolation of patients, screening and regular self-examination, “including in the genital and anal area” (which requires great flexibility).

But unlike the World Health Organization (WHO) last week, the DGS did not see fit (or did not dare) to recommend that homosexuals reduce their number of sexual partners.

1.1 million doses available in the United States… for 1.6 million people

On the other side of the Atlantic, the United States is also stepping up its fight against the epidemic. The country has 7,102 cases, more than any other in the world, including 25% in New York State alone. This Thursday, the Ministry of Health declared the epidemic a “public health emergency”.

“We call on all Americans to take the issue seriously and help us stop this virus” said Health Minister Xavier Beccera. 99% of confirmed cases are homosexual men and the population at risk is estimated at more than 1.6 million people.

The federal government says it has more than 1.1 million doses of the vaccine at its disposal, of which 600,000 have already been distributed and has ordered nearly 7 million in total. The authorities also say they have the capacity to carry out up to 80,000 tests per week.

1.7 million doses of tecovirimat, an antiviral originally developed against historic smallpox, are also available. Finally, the FDA may soon allow the vaccine to be injected subcutaneously, which could allow only one-fifth of a dose to be used for each injection.

“We are ready to take our response to the next level” concluded Xavier Beccera.

Nicolas Barbert

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