The smallpox vaccine is administered in France to people at risk of monkey pox (or Monkeypox). As of August 9, 54,585 doses of vaccine have been delivered to vaccination centers in Paris, Lyon...Which monkeypox vaccine? How effective? What side effects? How to make an appointment?

[Updated August 11, 2022 at 4:36 p.m.] Deleted since 1984, the smallpox vaccination is back in France in the face of the emergence of cases of the virus Monkeypox responsible for monkeypox. Of the vaccination centers open throughout France ( Paris , Lyon, Rennes, Lille, Nantes...) to prevent the spread of the virus. As of August 9, 54,585 vaccine doses of 3rd generation were delivered on the national territory reports Public Health France in his last point. Since August 10, 5 pharmacies (2 in Île-de-France, 2 in the Paca region and 1 in Hauts-de-France) are authorized to vaccinate against monkeypox said François Braun on France info . The experiment will last 2 weeks to see if it is appropriate to extend the vaccination campaign to other pharmacies. The Minister of Health specified that the vaccination will be only offered to those most at risk of the virus (list below). Appointments to get vaccinated can be made on Doctolib and la vaccination is free . Vaccination against monkeypox requires 2 doses whose delay (initially 28 days) was extended on August 5 speak Ministry of Health ' in order to guarantee the greatest number of people at risk access to vaccination '. The time between the two doses is not specified. According to estimates by the National Institute for Health Monitoring, the real vaccination coverage against smallpox is estimated at 50% for the French population born from 1972 to 1978 , 65% for those born between 1966 and 1971 and 90% for those born before 1966. People who have been vaccinated against smallpox during these years are normally protected against monkeypox. Which vaccine is used against monkeypox? Is it effective? Who should get vaccinated? Is it obligatory ? how many doses are necessary ? How to Get the Monkeypox Vaccine in Paris ? Where get vaccinated against monkeypox? How to make an appointment? What Side effects ?

Who should get vaccinated against monkeypox?

Vaccination against monkeypox is offered for prevention to people most exposed to the virus (list below) or post-exposure to contact cases of an infected person, in accordance with the recommendations issued by the High Authority for Health ( HAS ) on July 8. The people most at risk of the virus who are offered preventive vaccination are:

• men who have sex with men (MSM)
• trans people reporting multiple sex partners;
• people in a situation of prostitution;
• professionals working in places of sexual consumption, regardless of the status of these places

For contact cases of an infected person, the HAS recommended :

• if you have been vaccinated against smallpox as a child before 1980: you should receive a single dose of monkeypox vaccine, except for immunocompromised people (3 doses).
• for child contact cases under the age of 18, vaccination should be considered on a case-by-case basis

HAS does not recommend, at this stage, pre-exposure vaccination of healthcare professionals caring for sick people, the usual hygiene measures and the wearing of personal protective equipment making the risk of contamination very low in practice.

Where to get vaccinated against monkeypox?

A center dedicated to vaccination against monkeypox opened at Paris July 26, Edison Health Center in the 13th district. The Regional Health Agencies (ARS) organize for their region the opening of places dedicated to vaccination against Monkeypox virus. In Ile-de-France (Paris), it is necessary for example to consult the site of the ARS Ile-de-France : in Normandy consult the ARS Normandy ; for the Rhône (Lyon) consult the ARS Auvergne-Rhône-Alpes ... The ARS publish on their websites the contact details of the vaccination sites for make an appointment . Depending on the region, vaccination may be offered in a health facility , in some CEGID ou au sein de centers de vaccination.

How do I find an appointment to get vaccinated? On Doctolib?

To get vaccinated against monkeypox, you must contact the place of vaccination beforehand to make an appointment. The list of vaccination locations is available on the ARS websites for each region. On Doctolib , since July 12, 2022, the 'monkey pox vaccination' pattern is available (you can enter it from the homepage of the site in the search field). The platform clarified on Twitter what to them appointment slots are opened directly on the fly by health establishments .

How to get vaccinated against monkeypox in Paris?

Des vaccination centers against monkeypox have opened in Ile-de-France announced the Regional Health Agency of Ile-de-France ( ARS ). ' They are communicated to people in high-risk contact cases, potentially eligible for vaccination. They can also be solicited directly by people who know they are subject to risky contacts of a confirmed case to assess the indication for vaccination ' specifies the Agency which publishes the list of places on its site . The vaccination offered in these places is free. but it requires making an appointment in advance.

What is the name of the monkeypox vaccine?

According to the decree published in Official newspaper on May 26, two vaccines can be administered in France against monkeypox (same principle of action, similar efficacy): the vaccine IMVANEX (already authorized in Europe) and the vaccine JYNNEOS . These two vaccines are manufactured by the firm Bavarian Nordique located in Denmark. July 25, the European Commission has approved l'extension du vaccine IMVANEX (originally against smallpox) of the Bavarian Nordic group against spread of monkeypox virus , announced the Danish group in a communicated .

To know : the smallpox vaccine manufactured until the 1980s by Doctor Pourquier's Vaccine Institute was called 'Pourquier Vaccine'. The vaccine produced by Sanofi-Pasteur was the ' Aventis vaccine '.

What vaccine is given against monkeypox?

Two vaccines are given against monkeypox: Imvanex© and Jynneos©. Both are 3rd generation smallpox vaccines . They are preferred by health authorities 'in view of the tolerance profile, better than that of vaccines of 1 ^re and 2 ^and generation and efficiency' I explained the HAS. The Imvanex© vaccine from the firm Bavarian Nordic has a European Marketing Authorization (MA) since July 2013 and is indicated for active immunization against smallpox in adults. 'It presents a mode of administration and a much more favorable safety profile than those of 1st and 2nd generation vaccines, while ensuring comparable immunogenicity.' It is marketed in the United States under the trade name Jynneos© and can also be administered in Europe against monkeypox. The smallpox virus belongs to the group of orthopoxvirus . This group includes, in addition to the smallpox virus, 3 viruses transmissible to humans, the vaccine virus (virus that affects cows) which is used in the vaccine (similar to smallpox but less harmful). Smallpox vaccine is a live, attenuated virus vaccine. There have been three generations of smallpox vaccines:

• 1st generation vaccine: ancient replicative live attenuated vaccine
• 2nd generation vaccine: ancient replicative live attenuated vaccine
• 3rd generation vaccine: non-replicating live attenuated vaccine (which cannot multiply in the human body)

1st generation and 2nd generation vaccines against smallpox are not no longer used since 1984 due to the eradication of smallpox. “These vaccines required a particular injection technique (injection by bifurcated needle), showed reactogenicity and serious side effects (encephalitis, encephalopathy, eczema vaccinatum, progressive or general vaccinia, heart damage, etc.)' reminded the HAS in May 2022.

How many doses do you get?

The monkeypox vaccination schedule includes 2 doses  (or 1 single dose for people who have already been vaccinated against smallpox, and 3 doses for immunocompromised people). The Ministry of Health has lengthened the time between the two doses of vaccine (previously 28 days apart) without specifying how long. ' As part of the preventive vaccination strategy against the Monkeypox virus and in order to guarantee the greatest number of people at risk access to vaccination , the Ministry of Health and Prevention recommended that vaccination sites lengthen the interval between the 1st and 2nd dose for non-immunocompromised people ' reads in a fact sheet 'Monkey pox' published on 5 August speak Ministry of Health . ' Patients whose 2nd dose would be assessed as a priority by a doctor for health reasons, treatment or their exposure will obviously benefit from appointments. 2nd dose appointments not scheduled to date may be scheduled later as the vaccination campaign progresses ' specifies the ministry. The HAS specifies that the Imvanex© and Jynneos© vaccines are interchangeable.

How effective is the monkeypox vaccine?

There is no vaccine directly targeting Monkeypox but the one against smallpox that is administered would be 85% effective according to' Pastor Institute . Several studies have demonstrated the persistence of the immune response in individuals vaccinated against human smallpox in childhood, three clinical trials have also shown that the administration of a dose of Imvanex® in a person who has previously received a primary vaccination with another type of smallpox vaccine confers a booster effect, even very far from this primary vaccination. 'Vaccination does not confer immediate protection, also it is important to continue to avoid any risky contact with a person infected with the Monkeypox virus or suspected of being so' recalled the DGS in July.

What are the side effects of the monkeypox vaccine?

The side effects of the monkeypox vaccine are the same as those of the smallpox vaccine. 3rd generation vaccines (such as Imvanex and Jynneos) present 'a much more favorable safety profile than those of 1st and 2nd generation vaccines, while ensuring comparable immunogenicity' reassures the HAS. According to CPR you vaccine Imvanex , them most commonly observed adverse reactions in clinical trials were injection site reactions and systemic reactions commonly seen after vaccination: headache, myalgia, injection site pain, injection site erythema, injection site swelling, injection site induration, injection site pruritus, fatigue. These reactions were mild to moderate in intensity and resolved without treatment within seven days of vaccination. 'To notice that people with atopic dermatitis developed more local and systemic symptoms after vaccination' specifies the Medicines Agency in a May 26 briefing note. In a non-placebo-controlled clinical trial comparing the safety of Imvanex in people with atopic dermatitis and in healthy subjects, people with atopic dermatitis experienced erythema (61.2%) and swelling (52.2%) ) at the injection site at a higher frequency than in healthy subjects (49.3% and 40.8%, respectively). 7% of people with atopic dermatitis experienced a flare-up or worsening of their condition. The 1st and 2nd generation vaccines against smallpox - which are no longer authorized today - exhibited reactogenicity and serious side effects : encephalitis, encephalopathy, eczema vaccinatum, progressive or general vaccinia, heart attacks... They are contraindicated in many cases and in particular in pregnant women, immunocompromised subjects and children under one year old.

When was the smallpox vaccine invented?

The English physician surgeon Edward Jenner (1749-1823) developed the first smallpox vaccine in 1796. Smallpox was the first vaccination in the history of mankind, long before Pasteur. The first smallpox vaccinations in France took place in 1799 (150,000 in 1806 to 750,000 in 1812).

Who discovered the smallpox vaccine?

The english surgeon doctor Edward Jenner discovered the smallpox vaccine.

Is the smallpox vaccine compulsory?

In France, vaccination against smallpox was compulsory from 1901 to 1979 remind him Ministry of Health . On this date, it was decided to no longer impose primary vaccination against smallpox (Law 79-520 of July 2, 1979) before, finally, completely abolish vaccination reminders in 1984 (Law 84-404 of May 30, 1984) long after the occurrence of the last case of smallpox in the world (1977 in Somalia) and when all the countries adhering to the WHO also decided to stop routinely vaccinating against this disease . However, the possibility of having recourse to it has been retained thanks to a regulatory text which states that: ' in the event of war, public calamity, epidemic or threat of an epidemic, vaccination or re-vaccination against smallpox may be made compulsory by decree or by prefectural orders for anyone, regardless of age '. Regarding vaccination against monkeypox , she is not not mandatory currently.

What are the contraindications for the smallpox vaccine?

According to CPR from Imvanex® vaccine authorized in Europe , it is contraindicated in case of hypersensitivity to the active ingredient or to any of the excipients (Trometamol / Sodium chloride / Water for injections) or to residues present in trace amounts ( chicken protein , benzonase, gentamicin and ciprofloxacin ). Finally, vaccination should be postponed in the event of severe acute febrile illness (high fever).

Sources :

- Monkeypox, evolution of the course of action, DGS, July 8, 2022

- ANSM opinion on vaccination against Monkeypox virus, ANSM, June 15, 2022

- Opinion No. 2022.0034/SESPEV of 20 May 2022 from the College of the High Authority for Health relating to vaccination against Monkeypox. HAS. May 20, 2022.

- Case of Monkeypox in Europe, definitions and course of action May 20, 2022. Santé Publique France.

- Use of the smallpox virus as a biological weapon. INVS, October 25, 2001.

- Smallpox Vaccine, Jun 2021, The Merck Manuals

- Smallpox Prevention and Treatment, CDC

- Opinion on the revision of the smallpox plan, High Council for Public Health, 21 December 2012

- Pastor Institute

Source journaldesfemmes.fr