Is it still worth getting vaccinated against mpox (formerly known as monkeypox, after the virus that causes the disease)? The French National Authority for Health (HAS), an independent organization responsible for guiding French health policy, has answered in the affirmative, advising on Monday, September 2, that people at risk get an injection of the product from Bavarian Nordic, marketed in Europe under the name Imvanex.
This target population has not changed since the last epidemic outbreak outside Africa in 2022-2023. It includes men who have sex with men (MSM), trans people reporting multiple sexual partners, people doing sex work, people working in sex locations (whatever the status of these places), and finally people sharing the same living space as those previously mentioned.
All in all, these vaccine recommendations apply to around 300,000 people, with Santé Publique France agency estimating the MSM population with multiple partners at around 250,000, and authorities putting the number of people in sex work at between 30,000 and 40,000.
"We're facing a real pandemic risk," said infectiologist Anne-Claude Crémieux. "This is perhaps one of the rare occasions when, faced with a potentially pandemic virus, we are in a position to intervene while the disease is still confined to a limited target population. We need to learn from the past." Crémieux, the president of the HAS technical committee on vaccinations, which issued the opinion, was referring to the first mpox outbreak outside Africa, which affected 117 countries worldwide in 2022 and 2023, causing some 100,000 cases of the disease, which was previously endemic only in a handful of African countries.
The health stakes are now twofold, since the subclade 2b, which was at the origin of the outbreak two years ago, has continued to circulate in 13 countries outside Africa, with France among them – 126 cases have been reported in the country since the beginning of the year, including only one woman. And the new sub-clade 1b, identified a year ago in the Democratic Republic of Congo (DRC) and spreading rapidly among its neighbors in Africa, could spread worldwide, as its predecessor did.
The target population in France has remained unchanged since 2022, even though the disease mainly infects children in Africa. The two sub-clades of concern to the international community today are mainly spreading sexually among populations with multiple partners. The first cluster identified in April 2024 for the new sub-clade 1b was indeed among MSM in Kwango province, DRC.
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