To stop the spread of monkeypox, the return of smallpox vaccination is being discussed. The vaccine is expected to offer good protection but is also known for its side effects.
Munich – The cases of monkey pox are increasing in Europe. The virus, which is associated with lesions in the form of smallpox, is currently being viewed critically in view of the lessons of the corona pandemic. The question of how the administration of the common smallpox vaccine could counteract the spread of the infection is now the subject of political debate.
Smallpox vaccination against monkeypox: Germany stores millions of vaccine doses, Lauterbach orders 44,000 Imvanex syringes
The smallpox virus family is large. As in the textbook Medical Virology (Doerr et al.) can be read, but if by the Smallpox is the variola virus (orthopoxvirus variolae), the natural host of which is man. This virus has been considered defeated since the WHO’s large-scale eradication campaign in the 1960s. As the organization reported in 1987, a man from Somalia infected on October 26, 1977 was the last known sick person. Other smallpox species whose hosts are animals (animal smallpox) continued to exist – including monkeypox, discovered in 1958. Humans are not the actual target of the virus (false host); the monkeypox virus, known as orthopoxvirus simiae or monkeypox virus (MPV), was previously not known to be particularly contagious. The infections with MPV, the both in the 1980s and 1990s on epidemic events in the Congo ran along a traceable chain of infection and benefited from the deficient hygienic conditions in their spread.
Since the variola virus, which is a threat to humans and also known as smallpox, was believed to have been eradicated, how the Pharmaceutical Newspaper comprehensively, vaccine production has largely ceased over the years due to a lack of demand. The only preparation available as a vaccine is Imvanex. The active ingredient is produced by the Danish vaccine company Bavarian Nordic and has been approved in the EU as a vaccine against smallpox since 2013.
According to Health Minister Karl Lauterbach (SPD), Germany now has “up to 40,000 doses” of Imvanex, which is approved for monkeypox in the USA. ordered. In addition, Germany supports a report by the Federal Ministry of Health, which dpa is available, according to 100 million smallpox vaccinations, two million of them for the WHO – it is not known which preparation is involved. The cans are held up so far according to the medical journal in case of a return of the variola virus.
Monkeypox: Smallpox vaccination once caused serious side effects
Since cases of monkeypox now appear internationally, the question arises whether preventive smallpox vaccination could stop MPV. Smallpox vaccination was compulsory for one-year-olds until 1975 in the FRG and until 1982 in the GDR. A vaccine was administered with the vaccinia virus, which is very similar to the variola virus; the vaccine protection brought, so that medical journal, also a “(cross) immunity (…) against the closely related cowpox or monkeypox”. However, since the vaccination was sometimes associated with serious side effects and even deaths, it was soon discontinued with the eradication of smallpox proclaimed by the WHO. By 1980 (GDR) at the latest, however, there were no more primary vaccinations in Germany. This means that almost everyone under the age of 50 in this country is not vaccinated against smallpox.
According to Lauterbach, people who have been vaccinated against smallpox should be well protected. Normal smallpox vaccine is “but not suitable for fighting monkeypox,” said the health minister. RKI boss Wieler agrees and draws attention to the side effects of smallpox vaccination. The monkeypox vaccine has significantly fewer side effects, according to the RKI boss.
While the head of the World Medical Association, Frank Ulrich Montgomery, to the Newspapers of the Funke media group stated that those who were vaccinated at that time also had “good protection” against monkeypox, reports the Pharmaceutical Newspaperthat several medical professionals, including Professor Dr. Leif Erik Sander from the Berlin Charité and Karl Simpson, director of the British life science company JKS Bioscience Limited, have different views. As early as July 2020, Simpson had postulated in the journal Vaccine that around 70 percent of the world’s population was no longer protected against smallpox, not least because of declining immunity.
In 2022, a research team led by scientist Eveline Bunge published a recent analysis in the journal Plos Neglected Tropical Diseases, evaluating monkeypox cases between 1970 and 2019. The number of illnesses increased tenfold during this time; however, the age of those affected has increased significantly. This result, according to which monkeypox would be of “global relevance”, strongly suggests that existing vaccination protection is declining. The Robert Koch Institute (RKI) assumes that due to the decreasing smallpox vaccination protection, infection through contact with MPV is becoming more and more likely. The Institute points out that the “(primary) transmissibility from person to person (…) has increased from originally 30 percent in individual cases in the 1980s to 73 percent of the cases documented in 1997 in the DR Congo”.
Smallpox vaccination: yes or no? Potential vaccination for monkeypox remains a cost-benefit analysis
To what extent the vaccination designed for smallpox is advisable in view of the current cases of monkeypox depends on many, largely unanswered questions. In particular, the fact that MPV seems to spread in such an atypical way is “quite unusual and must (…) be examined in detail and any further spread closely monitored,” says the author Friedrich-Loeffler-Institut (FLI) as early as Thursday, May 19, 2022. The big concern here is that the virus could have changed structurally; According to the Pharmaceutical Newspaper not infrequently.
In this case, it would be questionable how well Imvanex could help against monkeypox. Also side effects of the new vaccine, which dem Paul-Ehrlich-Institut (PEI) according to which it is only administered from the age of 18 can possibly only be statistically assessed in large vaccination groups. On the other hand, the US health authority Center for Disease Control and Prevention (CDC) Pointed out that data from Africa had shown that the smallpox vaccine Imvanex – known in the US as Jynneos – prevented up to 85 percent of cases of contracting monkeypox.
According to the CDC’s Jennifer McQuiston, “Those who are at high risk of serious illness, as well as contacts and medical staff, would benefit most from vaccination. Federal Health Minister Karl Lauterbach (SPD) also pointed out loudly dpa already pointed out the benefits that vaccination could bring not only preventively but also for those who are already infected. CDC epidemiologist John Brooks said loudly AFP also that immunocompromised people or people suffering from skin diseases are more at risk of monkeypox. Previous data indicate that same-sex sexual intercourse among men is a possible, but not exclusive, route of infection. The following admonished Montgomery especially younger people with increasingly changing sexual partners to be careful. (askl)