March 25, 2023

Monkeypox: The Ministry of Health will start vaccination on the thirteenth of this month. See eligible groups

With 46,000 doses available from the National Immunization Programme, the Ministry of Health Getting ready to start the vaccination campaign against Mbox (monkeypox). Implementation of the ban begins next Monday, the 13th, Health and Environmental Monitoring Secretariat Ethel Maciel reports to state.

The report was also able to view the technical report sent to the states and municipalities. According to the document, for pre-exposure vaccination, people with HIV/AIDS who have a “CD4 T-lymphocyte count of less than 200” and professionals who work directly with orthopoxviruses in laboratories would be eligible. For post-exposure, the group includes contacts of patients with suspected or confirmed disease, classified as high or medium risk exposure.

A doctor holds a vial of Jynneos vaccine, which protects against monkeypox. filming: Pascal Guyot/AFP

Given that vaccinations are no longer on the market (the ministry bought 49,000, but received only 46,000, according to the document), the vaccination strategy continues until supplies run out.

Brazil received its first shipment of immunization kits, consisting of 9,800 units, in October. Through the unit, the National Health Surveillance Agency (Anvisa) approved the use of Jynneos / Imvanex vaccines in August, extending the exemption from registration for another six months in February this year.

The document also provides the epidemiological design of the outbreak in the country through week 7 of 2023 (2/12/2023 to 2/18/2023). In total, 50,803 suspected cases of smallpox disease were reported: 10,301 confirmed (20.3%); 339 (0.7%) rated as probable; 3665 (7.2%) suspected and 36498 (71.8%) neglected. During this period, 15 deaths were recorded.

The cases curve shows growth from July and peak in August. Then, from September, a downward trend, although cases continue to be reported. This insistence, according to the document, is what justifies the need for the campaign and focus on patients who are likely to exacerbate the condition.

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“Given the epidemiological panorama of Mpox infection, with continued confirmed cases in Brazil, and despite a declining trend worldwide, the frequency of deaths and the incidence of morbidity and mortality are higher among people with HIV/AIDS (PLWHA), especially in those who have An immunological status of CD4 T-lymphocytes <200 cells,” the document states.

“Fortunately, the pandemic scenario is a deterioration scenario,” says Ethel. “Because the virus is still circulating – there is no eradication, but control – it is important that we vaccinate to further protect those most likely to develop more severe clinical cases or who are more susceptible to the virus.”

Asked why vaccination has only begun now, Ethel said, “We’ve had (the government) with unused doses and we asked Anvisa for permission to use the vaccines.”

a Estadao He tried to speak directly with the Ministry of Health, through the press office, but received no response.

In the report, former health minister Marcelo Quiroga said that “Anvisa granted registration of vaccines on an exceptional and monitoring basis,” and that “the technical field recommended that a survey be carried out at the responsibility of researchers from the Oswaldo Cruz Foundation.”

By the end of the term, Conep (National Research Ethics CommitteeQuiroga said) did not agree to the research protocol. “To the best of its knowledge, Conep has not accepted the free and informed consent (TCLE) form provided by the researchers.”

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Initially, the file will transfer to federal units only the amount sufficient to immunize 50% of the population targeted for vaccination prior to exposure. “Sending more doses will depend on the progress of vaccination, and depending on local demand, follow-up units should request the Ministry of Health to send additional shipments,” the document says.

And he adds, “A strategic stock will be maintained at the state and central levels, with the aim of redistribution in light of the development of the epidemiological scenario and the occurrence of new cases.” Health estimates there are just over 16,300 eligible people living with HIV/AIDS in the country, according to data from the public health system for the last six months of last year.

The vaccine to be used is Jynneos which, according to the volume, is a “live vaccine”. “Produced from the modified Vaccinia Ankara-Bavarian Nordic (MVA-BN) strain, it is an attenuated, non-replicating orthopoxvirus against smallpox and monkey pox, which induces humoral and cellular immune responses to orthopoxviruses.

The vaccination schedule is two doses (0.5 ml each), four weeks (28 days) apart. It is indicated for use in adults 18 years of age and older.

Eligible groups for pre-exposure vaccination

1 – People living with HIV / AIDS: cisgender men, transvestites, transgender women; is 18 years of age or older; and with an immune status defined by a CD4 T-lymphocyte count of less than 200 cells in the past 6 months.

2 Laboratory professionals working directly with Orthopoxvirus in Biosafety Level 3 (NB-3) laboratories, 18 to 49 years of age.

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Eligible groups for post-exposure vaccination

1 – Persons who have been in direct contact with the bodily fluids and secretions of suspected, probable or confirmed infected persons with ampoxide, and whose exposure is classified as high (direct exposure to the skin, mucous membranes of the skin or respiratory secretions) or medium (indirect) contact, but nearby in the same room or in the indoor physical space) danger.