Haute Autorité de Santé – Monkeypox: Responsive Vaccine Strategy for the First Time Specified for Recipients and Children

On May 20, 2022, it published a preliminary recommendation for a vaccine strategy against the virus Monkeypox (Monkey Pox). The Director General of Health was subsequently contacted to provide details of responsive immunization strategies for two populations: first-time recipients and children. To do this, in the opinion of June 16, 2022, HAS considers the definition of persons at risk and persons of contact under the Public Health France (SPF), the opinion of the National Agency for the Protection of Drugs and Health Products (ANSM). [Lien de l’avis] About the vaccination of people vaccinated against smallpox in childhood and the use of smallpox vaccine 3e Generations in children, a number of research and clinical trials, in addition to WHO recommendations dated June 14, 2022.

One dose for the first vaccinated risky contact, three if they are immunocompromised

Immunizations against human smallpox were mandatory in France until 1980 (1979 for early vaccination, 1984 for boosters). HAS maintains the presence of an indeterminate waffle spot to establish evidence of previous smallpox vaccination, with or without a document proving the validity of the vaccine.Characteristics of those who have been vaccinated with 1 vaccineD Or 2e Generation

Although several studies cited in the HAS opinion have shown stability of the immune response in people vaccinated against childhood human smallpox, three clinical trials have also shown that a single dose of Imvenex administration3 There is also a booster effect far beyond the initial vaccine for a person who has previously been vaccinated with another type of smallpox vaccine.

HAS therefore recommends single dose administration of Imvenex vaccine3 For people in high-risk contact who have been vaccinated against smallpox with 1 vaccineD Generations before 1980.

In special cases where people at risk are immunocompromised patients, previous vaccination with other smallpox vaccines does not change the initially recommended immunization schedule of this population, i.e. 3 doses of Imvenex.3.

Post-exposure juvenile immunizations will be considered on a case-by-case basis.

Number of cases of virus infection Monkeypox France is improving rapidly but does not currently express concern for children. Before the eradication of smallpox, smallpox vaccine has been administered to infants and young children, including first and second generation vaccines, Imvenex vaccine.3 Only allowed in adults.

In order to issue his opinion, the available research has been analyzed. Several of them, conducted in African countries, show that children are more likely to develop severe forms of the disease and that mortality is higher in this population. Of the 35 laboratory-confirmed cases (of the 71 declared cases) that affected the 2003 epidemic in the United States, 11 involved children between the ages of 6 and 18, 2 of whom developed a severe form of the disease. Illness 7

In addition, though the Imvanex vaccine3 Several studies on other vaccines using the same platform as Imvanex, currently only approved for adults3 (The Modified virus Ankara – MVA), higher than the recommended doses for Imvenex3, Showed better tolerance in infants older than 4 months. In addition, no adverse effects were reported after vaccination – including infants and children – during the outbreaks in the UK in 2018 and 2019.

Which also relied on the opinion of the ANSM Indicates that immunogenicity data are insufficient to make a complete decision about the benefits / risk balance 3 related to the administration of smallpox vaccinee Generations within the pediatric population. But ANSM considers it Security information History obtained with the vaccine from 1D Protection data are available regarding the “MVA Platform” used as a vector for vaccination against other pathogens (Ebola virus, malaria and tuberculosis) as well as other pathogens (Ebola virus, malaria and tuberculosis). 3 in favor of vaccine usee Generations, after evaluation in each case in each child, post-exposure as part of reactive vaccination.

Based on these different components, there are:

  • It has been suggested that reactive vaccination (as defined by the SPF) of exposure to at-risk children may be considered to protect exposed children and is more likely to develop severe forms of the disease, especially the most fragile and immunocompromised. However, in the absence of clinical data on the safety of 3rd generation vaccines (indirect, reassuring safety data is available), HAS recommends that vaccinations under the age of 18 be considered on a case-by-case basis only by experts and in a shared medical decision. Within the framework, and with the consent of the parent (or legal guardian of the child) and, if applicable, the adolescent, after a rigorous assessment of the benefits and risks for the minor concerned.
  • The EMA recommends expediting the conduct of clinical trials in the pediatric population by evaluating the efficacy and safety of third-generation smallpox vaccine aimed at expanding the indications of pediatric population.

HAS will comply with this initial recommendation only if data from clinical trials of pediatric populations are available. And based on new epidemiological and clinical data. It emphasizes the importance of having more precise data on the mode of human-to-human transmission for early detection cases, epidemic monitoring data, and additional real-life data on the effectiveness and tolerance of smallpox vaccines.e Operated by generation, pre-exposure and post-exposure viruses MonkeypoxData on the efficacy and tolerability of booster doses in severe size prevention and transmission of the disease in different subgroups of the population, as well as in people vaccinated against smallpox in childhood.

Finally, In France, men are identified as having sex with one or more men (MSM), There is Forcibly On Essentials Inform them about the risk of infection during physical contact Together or off Intimate. He also recalled the importance To comply with infection prevention measures Virus Monkeypox Both for the general public and For nursing staffIn accordance with the recommendations of the High Council for Public Health In her 24’s opinion Last May.

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