A New Insight to Prioritize the Monkeypox Vaccine

“The global outbreak of Monkeypox is clearly unusual and concerning”, said WHO director Tedros Adhanom Gebreyesus. A significant global outbreak of monkeypox virus that started in May 2022 was primarily found in networks of men who have sex with men (MSM). Global vaccine supplies are limited in the current outbreak.

A modeling study to explore optimal allocation of vaccines against monkeypox virus (MPXV) provides a road map for public health to maximize the impact of a limited supply of vaccines. A recent study has revealed that prioritizing vaccines to larger networks with more initial infections and greater potential for spread is best. The article is published in CMAJ (Canadian Medical Association Journal).

Test Your Knowledge on Monkeypox
Introduction:

Monkeypox is a rare viral infection caused by the monkeypox virus, which belongs to the same family of smallpox. It typically occurs in central and western Africa. Sometimes, small clusters or isolated infections are diagnosed in other countries.

Monkeypox does not spread because of monkeys. The name originates from the initial discovery of the virus in monkeys in a Danish laboratory in 1958. There are two forms of monkeypox, a milder west African strain and a more severe central African, or Congo strain. The current outbreak involves the west African strain, although not all countries have looked into this.

Important Facts on Monkeypox
With the rapid increase in the 2022 outbreak of monkeypox cases, the following facts may help ease the alarming rates of misconceptions and concerns that have coursed among public.

Anyone can spread monkeypox through contact with body fluids, monkeypox sores, or shared items (such as clothing and bedding) that have been contaminated with fluids or sores of a person infected with monkeypox.

‘Prioritizing vaccinations for a larger network, a network with more initial infections and a higher potential for epidemics, can prevent more infections.’
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“We hope that these insights can be applied by policy-makers across diverse and dynamic epidemic contexts across Canada and beyond to maximize infections averted early in an epidemic with limited vaccine supply,” says Dr. Sharmistha Mishra, MAP Centre for Urban Health Solutions, Unity Health Toronto.

As of November 4, 2022, there were 1444 cases of MPXV in Canada, disproportionately among gay, bisexual, and other men who have sex with men (GBMSM). A very limited supply of smallpox vaccines is available and is being prioritized to populations experiencing disproportionate risks.

Factors Influencing Vaccine Allocation

Researchers modeled two hypothetical cities as interconnected networks with a combined GBMSM community size of 100,000. The team then varied the characteristics of the two cities across a range of plausible settings and simulated roll-out of 5000 vaccine doses shortly after the first detected case of MPXV.

They found that the strongest factors for optimal vaccine allocation between the cities were the relative reproduction number (epidemic potential) in each city, the share of initial cases, and city’s (or network’s) size. If a larger city had greater epidemic potential and most of the initial cases, it was best to allocate most vaccines to that city. The team varied the reproduction number with a single parameter, but they highlight how many factors could influence local epidemic potential, including the density and characteristics of the sexual network, access to prevention and care, and the underlying social and structural contexts that shape both sexual networks and access.

“Under our modeling assumptions, we found that vaccines could generally avert more infections when prioritized to a larger network, a network with more initial infections and a network with greater epidemic potential,” writes Jesse Knight, lead author and PhD candidate at the University of Toronto and MAP Centre for Urban Health Solutions, Unity Health Toronto. “Our findings further highlight the importance of global vaccine equity in responding to the outbreaks, and also in preventing them in the first place,” he says.

The study emphasizes the interconnectedness of regions and that a population-level perspective is necessary.

“Strategic prioritization of a limited vaccine supply by network-level risk factors can maximize infections averted over short time horizons in the context of an emerging epidemic, such as the current global MPXV outbreak,” conclude the authors.

Source-Eurekalert

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