Government should work on procuring vaccines vs monkeypox

MANILA, Philippines — The government should start looking at how the Philippines can procure vaccines for monkeypox as part of its early preparation if ever a confirmed case will be documented in the country, according to an infectious disease expert.

“We always put importance on increased awareness and how to prepare for this. Testing recommendations, infection and prevention control are part of that,” Dr. Rontgene Solante said in a recent forum organized by the Philippine College of Physicians.

“In the health care setting, we must be ready with our isolation rooms and I think lessons learned with the ongoing COVID-19 pandemic will teach us more lessons concerning these emerging infections, including what we have now, that is the monkeypox. These will also include public health measures,” Solante added.

At present, two vaccines for monkeypox are available, which were approved in 2019, according to the expert.

“One is the Jynneos vaccine, which is licensed in the United States for prevention of monkeypox and smallpox. The other one, ACAM2000, is licensed also for the prevention of smallpox, but data is telling us that it is also effective in the prevention of monkeypox,” he said.

He pointed out that if one had smallpox vaccination before, it is estimated that the individual would still be protected 85 percent from getting monkeypox.

“So the overall risk of the general population is considered low and lower, especially for those aged 60 and above who have received smallpox vaccination in the past, which means they still have that level of immunity. So you can be protected with this,” Solante said.

“(These are) some of the agreements of some experts, but there is always the potential of transmission to this broader population. It will also be possible, especially among specific population, where you have higher risks because of immunocompromised conditions, such as young children, pregnant women… then the next group at risk will be from the frontline health care workers,” he added.

At present, most countries give protection among those who are at high risk, like laboratory and health care personnel with risk of occupational exposure, according to the expert.

“This can be given as pre-exposure prophylaxis, but in other countries also, they are giving now these as post-exposure prophylaxis for persons of high-risk or intermediate-risk exposure,” he said.

“There are limited stocks of these vaccines and (they are) not readily available, but this is one intervention that vaccine can be an important part of prevention to cut the chain of transmission,” he added.

Solante noted that there are four generations of vaccine for smallpox that are being used now for monkeypox, the one being used in most countries is the third-generation vaccine IMVANEX, which utilizes two doses of the vaccine 28 days apart.

Dr. Nina Gloriani, another infectious disease expert, agreed that the smallpox vaccine could be used for monkeypox.

“But this is not available to the general population. Its stockpile is also not enough because we used to give smallpox vaccine only to those going to Africa,” Gloriani said at the Laging Handa public briefing yesterday.

The Philippines has no case of the monkeypox so far, according to Solante.

“Hopefully, it will not enter into our country,” he said.