Vaccination against monkey pox, or “monkeypox”, is no longer recommended only for people in direct or indirect contact with the epidemic. In an opinion issued on Friday July 8, the High Authority for Health (HAS) recommends an injection “preventive” to “groups most exposed to the virus” : men having homosexual relations, trans people with multiple partners, those in a situation of prostitution and professionals working in places of sexual consumption.
As of July 7, Public Health France reported 721 confirmed cases, including 473 in Île-de-France. Among the contaminations for which sexual orientation is given, 98% affect men who have sex with other men; 75% of patients declare having had at least two partners in the three weeks before the onset of symptoms.
“Taboos of homosexuality”
“The virus has affected a group and is spreading within it, the preferred mode of transmission being prolonged contact with the skin.notes Jean-Daniel Lelièvre, head of the infectious diseases department at the Henri-Mondor hospital in Créteil. But it is not a sexually transmitted disease: sexual fluids are probably not the source of contamination. »
The “sexual dimension” of the most vulnerable populations in France in the face of monkeypox largely explains the ineffectiveness of the “ring vaccination”, advocated by the HAS since May 24: target people in contact with a confirmed case, then contact cases of contacts. A “tracing” based on the communication of personal and sensitive information. “Homosexuality is still subject to very important tabooslaments Professor Jean-Daniel Lelièvre. It is no more obvious for the caregiver to question the patient about his possible contact cases, than for the latter to inform the people likely to be contaminated by him. »
With regard to exposed healthcare personnel, HAS also recommends that vaccination be only considered on a case-by-case basis. “They have, in principle, personal protective equipment in the event of suspicion of monkeypox, which protects them from the slightest infectionrecalls Emmanuel Piednoir, infectious disease doctor at the Avranches-Granville hospital center. The case by case mainly targets the doctor who, having not observed skin lesions, would learn after the fact of the contamination of a patient. »
Third generation vaccine
The director general of health, Jérôme Salomon confirmed on Friday that the opinion of the HAS would be ” followed “without mentioning “difficulties in accessing this vaccine” : “We are now in a position to meet the needs of the centers in the coming weeks. » The Ile-de-France Regional Health Agency specifying that a “ten sites” would be accessible to the public targeted by the new recommendations, starting next week.
Faced with monkeypox, the vaccination schedule consists of two doses, 28 days apart, of the third-generation smallpox vaccine. “As effective as the first two, but with much lower side effectsdistinguishes the virologist Christine Rouzioux. Since smallpox and monkeypox belong to the same class called orthopoxviruses, the immunity of one at least partially induces that of the other. » Because if the vaccines are 85% effective against smallpox, the studies are less provided with regard to Monkeypox. “The situation is unprecedented.reports Emmanuel Piednoir, the virus is spreading this year almost exclusively between humans, when the previous epidemics, in Africa, came from the consumption of meat. »