The World Health Organization’s Strategic Advisory Group of Experts on Immunization (SAGE - WHO) recommended preventive vaccination for groups at "high risk of exposure" to monkeypox. In turn, he emphasized the need to "improve routine coverage of polio vaccination" in the face of the increase in cases in different regions of the world and reiterated the need to apply boosters against Covid-19.
The recommendations are the result of the meeting that SAGE held from October 3 to 6 where issues were reviewed on vaccines against Covid-19 that contain variants, interim guidance on immunization against monkeypox, candidate vaccines against syncytial virus respiratory, the Immunization Agenda 2030 and the eradication of polio.
In turn, the Committee received information on the Sudanese Ebola virus outbreak in Uganda, possible vaccines and the proposed vaccination trial.
Regarding monkeypox, the expert group "recommended primary preventive (pre-exposure) vaccination for groups at high risk of exposure."
"The group most at risk for exposure in the current outbreak is gay, bisexual or other men who have sex with men with multiple sexual partners. Others at risk include people with multiple casual sexual partners; sex workers; healthcare workers at repeated risk of exposure; laboratory personnel who work with orthopoxviruses; clinical and healthcare laboratory personnel who perform diagnostic tests and outbreak response personnel," it was indicated.
Likewise, they assured that "the level of infection risk can be used to prioritize in the event of limited vaccine supply."
In addition, it recommended "post-exposure vaccination (PEPV) for close contacts of cases, ideally within four days of first exposure and up to 14 days in the absence of symptoms."
In relation to what type of vaccines, he pointed out that for healthy adults, any of the three available vaccines is appropriate and for whom replicating or minimally replicating vaccines are contraindicated, non-replicating vaccines should be used.
SAGE emphasized that "research on monkeypox has been neglected in previously affected countries" and recommended generating "evidence on the epidemiology and epizoonotic status of the disease and the relationship with animal vectors."
Regarding polio, the experts expressed concern "about the renewed circulation of wild poliovirus 1 (WPV1) in Pakistan; and about the continued detections of WPV1 in southeastern Africa" and about "the continued transmission of vaccine-derived poliovirus type 2 (VDPV2), particularly in the African region and in Yemen, as well as detections in New York, London and Jerusalem.
In this context, he emphasized the need to "increase efforts to improve routine vaccination coverage" against this disease.
In reference to Covid-19, he noted that "achieving high and equitable rates of serial primary vaccination with vaccines with ancestral strains remains the top public health priority."
About the four bivalent mRNA vaccines that contain variants including BA.1 or BA. 4-5 in combination with the ancestral virus reported that they were authorized for use as a booster dose, but warned that there is still not enough data to make a preferential recommendation over those that were already being applied (with ancestral viruses).
Regarding Respiratory Syncytial Virus (RSV), he analyzed results from trials of new vaccines but warned of the need for more data in low- and middle-income countries to understand "the full public health potential of these vaccines."
Finally, on the ongoing outbreak of the Sudan Ebola virus in Uganda, he reported that as of October 6 there are 44 confirmed cases, 20 suspected cases and 10 deaths reported in five districts of that country and indicated that vaccines against the Ebola virus from Zaire (an African country currently called the Democratic Republic of the Congo) do not offer cross-protection against that from Sudan, for which there are still six vaccine candidates in development.
