Monkeypox vaccine: side effects, effective?

MONKEYPOX VACCINATION. Preventive vaccination against monkeypox virus (Monkeypox) is recommended for populations at risk. List of vaccination centers in France, pharmacies, side effects and effectiveness of the vaccine.

[Updated October 6, 2022 at 3:56 p.m.] Preventive vaccination against the monkeypox virus (Monkeypox) is recommended in France for populations particularly at risk. As of October 2, 112 777 doses against monkeypox were administered in France. Vaccination against monkeypox is possible ' in designated community pharmacies by the director general of the regional health agency 'which allows pharmacy preparers to administer the vaccine, indicates a decree published in the Official newspaper. This vaccination also takes place in the centres dedicated against monkeypox. This vaccination is carried out with the only vaccine available: Imvanex®  from Danish laboratory Bavarian Nordic . The protection is not 'immediate' warned the Directorate General of Health in July ' also it is important to continue to avoid risky contact with a person infected with the Monkeypox virus or suspected of being so' . Who should get vaccinated? Where to get vaccinated against monkeypox? In vaccination center ? In pharmacy ? Which ones? Do you need a arrangement ? Make an appointment required? What Side effects ? What efficiency? Addresses and practical guide to getting vaccinated against monkeypox.

Who should be vaccinated against monkeypox in France?

Abolished since 1984, the smallpox vaccination is back in France in the face of the emergence of cases of the virus Monkeypox responsible for monkeypox. Vaccination against monkeypox is offered in prevention for those most exposed to the virus (list below) or in post-exposition chez les cas contacts 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.

Can an appointment be made on Doctolib?

To get vaccinated against monkeypox, you have 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 .

Where to get vaccinated against monkeypox?

Depending on the region, vaccination may be offered in a health facility , in some CEGIDD or at vaccination centers. Since September 22, vaccination against monkeypox is possible ' in designated community pharmacies by the director general of the regional health agency ', indicates a decree published in the Official newspaper. 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 .

Where to get vaccinated against monkeypox in Paris?

In Paris, several vaccination centers are open:

  • AP-HP Bichat
  • Ap-HP Mercy Salpetriere
  • AP-HP Paris center Hotel Dieu
  • Ap-HP Saint-Antoine
  • Ap-HP Saint-Louis
  • Ap-HP Lariboisiere
  • Ap-HP Raymond-Poincaré
  • Ap-HP Avicenna
  • Ap-HP Tenon

The openings of c is centers ' 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 make an appointment before.

Where are the monkeypox vaccination centers located?

Vaccination against monkey pox is possible in health centers in mainland France and in the overseas territories. The list of vaccination sites is available on the Regional Health Agencies websites . An interactive map of the centers closest to you is available on .

  monkeypox vaccination center map
Map of monkeypox vaccination centers as of August 29, 2022

In which pharmacies can you get vaccinated?

Since September 22, vaccination against monkeypox is possible ' in designated community pharmacies by the director general of the regional health agency ', indicates a decree published in the Official newspaper. The list of pharmacies that vaccinate against Monkeypox is available at .

People vaccinated against smallpox are normally protected against monkeypox.

Is a prescription needed?

The people volunteers and affected by vaccination against Monkeypox can access vaccination based on self-declaration of their status target person for vaccination, after evaluation of the individual risk-benefit balance of this vaccination, specifies the Ministry of Health . People reporting a risky contact with a sick person can also access vaccination in the same way. So there is no need for a prescription. However, an appointment is required.

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 '.

Which lab produces the monkeypox vaccine?

A single laboratory produces the vaccine currently administered against monkeypox (Imvanex® in Europe/Jynneos© in the United States): the Bavarian Nordic Danish laboratory based in Copenhagen. He owns a European Marketing Authorization (MA) since July 2013 for active immunization against smallpox in adults. His vaccine is a 3rd generation antivariolic vaccine . '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' explains the HAS. 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 should be taken?

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) for non-immunocompromised people. 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 administration of a dose of Imvanex® in a person who has previously received a primary series 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. According to estimates by the National Institute for Health Surveillance, 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.

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. 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 human history, long before Pasteur. The first smallpox vaccinations in France took place in 1799 (150,000 in 1806 to 750,000 in 1812).

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 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 '. Re vaccination against monkeypox, it is not mandatory but recommended for people at risk.

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 :

- Monkey pox: pharmacies soon in the system, August 11, 2022, Government.

- 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