Great Britain is already vaccinating, Germany is still considering: monkeypox is spreading in many European countries. Experts emphasize that there is no reason to panic. Containing sources of infection is still the top priority. Is Smallpox Vaccination the Solution?
The monkeypox virus continues to spread in Europe. There are now four confirmed cases of infection and illness in Germany - one in Munich and three in Berlin, according to a report for the Health Committee of the Bundestag. Samples of other suspected cases would still have to be examined. Great Britain, where the first European cases have become known, is now reporting around two dozen infections. The kingdom therefore relies on vaccinations against monkeypox. But for whom is such a syringe useful? And will it also come to Germany?
For the ongoing vaccinations in the UK, a "third-generation" vaccine against smallpox, which is believed to be extinct in humans, says the head of the British health authority UKHSA, Susan Hopkins. Experts assume that vaccination against smallpox also protects against monkeypox, since the two viruses are very similar. Observational studies have found that smallpox vaccination is at least 85 percent effective against monkeypox.
However, Hopkins emphasizes that there will not be a large-scale vaccination campaign. "We use this in people who are at high risk of developing symptoms and we use it early, specifically within four or five days," she said.
Something similar is also conceivable for Germany. The Ministry of Health announced that the extent to which smallpox vaccination is recommended for contact persons and risk groups is still the subject of technical clarification. Federal Health Minister Karl Lauterbach announced this Monday that he would make preparations for the possible procurement of vaccines. "Vaccinating the general population is not under discussion here," he said. Rather, vaccination recommendations for people who are particularly at risk are being considered.
According to a report in the Financial Times, the European Center for Disease Prevention (ECDC) has asked EU countries to develop plans for a monkeypox vaccination. She recommends vaccination for close contacts at high risk of infection with monkeypox, if a suitable vaccine is approved in the country concerned. The Bavarian Minister of Health, Klaus Holetschek, also spoke out in favor of the vaccination: "I think it's important that we order the vaccine now." It is not about compulsory vaccination, but about the question of whether preventive vaccinations are possible and correct in the area of contact persons.
Early smallpox vaccinations used live vaccines containing reproducible smallpox viruses. Skin lesions, the characteristic scars of the smallpox vaccination, therefore usually formed at the puncture site. These vaccines are no longer available. Likewise, there is no vaccine specifically approved against monkeypox.
The only vaccine approved against real smallpox in the EU is Imvanex, writes the editorial network Germany (RND). This is a live vaccine that contains a genetically modified smallpox virus, Modified Vaccinia Virus Ankara (MVA). The vaccine virus is modified in such a way that it can neither trigger the disease nor multiply in the human body. The vaccine is only approved in Europe for the immunization of adults against smallpox, "but was previously made available for off-label use in cases of monkeypox," RND quotes the Danish manufacturer Bavarian Nordic A/S as saying.
According to the website of the European Medicines Agency (EMA), two doses of 0.5 milliliters are required at intervals of 28 days for effective vaccination protection. Anyone who has already received a smallpox vaccination only needs one dose - with the exception of people with a weakened immune system.
Clinical trials would suggest that Imvanex generates high antibody responses that are expected to protect against smallpox, the EMA said. However, it is not yet known how long this protection will last. And the protective effect against monkeypox is still unclear.
There will most likely not be a broad-based vaccination campaign - similar to Corona - in Germany. According to current knowledge, the Robert Koch Institute (RKI) still assesses the risk to the general population from monkeypox as low. This is also due to the fact that the virus is much more difficult to transmit than, for example, corona viruses.
"Monkeypox is actually not easy to transmit," says physician Christoph Specht ntv. Usually this happens through direct contact from animal to human. And the newly observed human-to-human transmissions were not about fleeting encounters, but about infection by droplet infection. "It needs direct contact. It's not like with Corona that an aerosol can float in the room and then someone gets infected," explains Specht.
In addition, there should be a certain immunity in the population - at least among the elderly. In the Federal Republic it was compulsory for one-year-olds until 1975, in the GDR compulsory vaccination was lifted in 1982. "That means that everyone born before that probably has very good protection," says Specht. Even if vaccination protection has probably decreased after a good 40 years, the World Health Organization (WHO) assumes that vaccinated people are more likely to have a milder course of the disease.
According to the current report, the federal government has stored about 100 million doses of smallpox vaccine. Of these, two million doses were donated to the WHO and stored for them. When and how the cans can be used has not yet been determined. According to the WHO, monitoring and rapid identification of new cases is more important than vaccination. This is the only way to contain outbreaks and prevent new sources of infection.