New guidelines for monkeypox. After having recommended, in May, the vaccination of adult high-risk contact cases, the High Authority for Health (HAS) released its opinion on Monday on the vaccination strategy for children and first-time vaccinators (persons vaccinated in childhood against smallpox). For people with high-risk contact cases who received smallpox vaccination with a first-generation vaccine before 1980, the authority thus recommends the administration of a single dose of the Imvanex vaccine (Bavarian Nordic).
But if the contact persons at risk are immunocompromised, previous vaccination with another smallpox vaccine does not modify the initially recommended schedule, ie three doses of Imvanex. For minors, although the Imvanex vaccine is currently authorized only in adults, several studies concerning other vaccines using the same platform as Imvanex, at higher doses, have demonstrated good tolerance in children. more than four months underlines the HAS.
The latter therefore recommends that vaccination of children under 18 “can be considered, to protect children exposed and possibly more likely to develop severe forms of the disease, in particular the most fragile and the immunocompromised”. The HAS recommends, however, that due to “the absence of clinical data on the safety of 3rd generation vaccines in the pediatric population” the vaccination of children should only be considered “on a case-by-case basis, by specialists alone and after a strict assessment of the benefits and risks for the minor concerned”.
Monkeypox, although mainly present in West and Central Africa, has spread rapidly around the world in recent weeks. Identifying the reservoir of this zoonosis (infectious disease that has passed from animals to humans) is complicated from a scientific point of view because several species can serve as hosts, like the coronavirus in origin of the Covid pandemic. Scientists are therefore calling for the development of increased surveillance of French wildlife, as recently explained to L’Express Barbara Dufour, professor of infectious diseases, zoonoses and epidemiology at the National Veterinary School of Alfort (ENVA).
If this virus can affect anyone (it is transmitted by contact with skin lesions or mucous membranes of a patient, by droplets, saliva, sneezing, and via contaminated objects, bedding, dishes …), the patients infected so far are “predominantly, but not exclusively, men who have sex with men”, according to the World Health Organization (WHO). But despite the precautions taken by the authorities, the disease is however most often benign, tempers Professor Gilles Pialoux, infectiologist, head of the infectious and tropical diseases department of the Tenon hospital (AP-HP) and vice-president of the French Society for the Fight against AIDS (SFLS).
