While contamination between humans by this virus is increasing in several countries, particularly in Europe, unrelated to a trip to Africa, the HAS recommends a “reactive” vaccination strategy, after exposure to a confirmed case, for “adult contacts at risk high monkeypox”.
This includes exposed healthcare professionals without personal protective measures, according to the notice made public.
This strategy “seems relevant given the incubation times of the disease and the vaccination strategy adopted in other European countries”, writes the HAS.
The incubation period for monkeypox is most often between 6 and 16 days, which can range from 5 to 21 days.
This vaccination must be done with the vaccine against smallpox “3rd generation only (in view of its tolerance profile, better than that of the 1st and 2nd generation vaccines and its effectiveness)”.
1st and 2nd generation vaccines have not been used for the general population since 1984, due to the eradication of smallpox.
A 3rd generation vaccine (non-replicating live vaccine that is to say that does not replicate in the human body), Imvanex from the Bavarian Nordic laboratory, has been authorized in Europe since July 2013 and indicated against smallpox in adults.
It also has marketing authorization in the United States, as Jynneos, for the prevention of smallpox and monkeypox.
The HAS recommends administering this vaccine “ideally within 4 days after the risky contact and at most 14 days later with a two-dose schedule (or three doses in immunocompromised subjects), spaced 28 days apart”.
These recommendations are part of a more global response “including in particular the provision of antiviral treatments not evaluated by the HAS but having a marketing authorization” for monkeypox, in particular for children for whom the vaccine is not is not allowed.
Beyond the reinforced measures for identifying and monitoring cases and vaccination in certain cases, the HAS judges that “in the current epidemic context, it is essential to adopt personal prevention and protection measures”.
