Europe considers ‘dose-saving’ to increase monkeypox vaccine, WHO seeks trials

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LONDON — Health officials in Europe are discussing whether to follow a move by the United States to expand scarce monkeypox vaccine stocks, with the World Health Organization asking for more data.

There have been 27,800 cases of monkey pox this year – mostly among men who have sex with men – and 12 deaths worldwide.

According to the WHO and other government health agencies, supplies of the main Bavarian Nordic injection, the only vaccine approved to prevent monkey pox and an important part of the global public health response, are scarce.

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On Tuesday, the US supported the use of one vial of the vaccine to deliver up to five separate doses — rather than a single dose — by injecting a smaller amount between the layers of skin. The vaccine is designed to be injected into a layer of fat under the skin.

This so-called ‘dose-sparing’ approach has been tried before with other vaccines, including for polio and yellow fever, but the evidence is limited whether it could work for monkeypox.

“The European Medicines Agency (EMA) will discuss the possibility of a dose-saving approach,” an EMA spokesperson told Reuters, adding that the regulator would discuss the strategy with the manufacturer, Bavarian Nordic and European countries.

The company did not respond to repeated requests for comment.

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The WHO “encourages the use of vaccines in trials that will help gather relevant information for their use in this outbreak,” a spokesperson told Reuters by email.

According to the US Food and Drug Administration, data collected in a 2015 clinical study https://www.sciencedirect.com/science/article/pii/S0264410X15008762?via%3Dihub showed that dose savings could work without sacrificing safety and efficacy sacrifice the vaccine.

Meanwhile, some governments in Europe are taking other steps to expand existing stocks. Britain, for example, is offering just one injection of the two-dose regimen to people most at risk as a temporary measure to provide at least some protection to a larger number of people.

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It is unclear whether either approach will result in adequate protection against monkeypox, which is usually a mild to moderate infection leading to flu-like symptoms and characteristic pus-filled skin lesions.

The virus disease has been endemic in parts of Africa for decades and was first reported outside those countries in May this year.

Adam Finn, a University of Bristol professor who is working with WHO Europe to advise on monkeypox immunization campaigns, said it “makes sense” to assess the dose-saving approach “as running out of vaccines is a very real potential concern.” with the monkeypox epidemic.” (Reporting by Jennifer Rigby and Natalie Grover; editing by David Gregorio)

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