Mpox investigation as new cluster sparks fears of possible mutation | CPT PPP Coverage

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If a long stretch of time has passed since vaccination, the health authority will need to assess if the vaccine has waned.

The health authority also needs a better understanding of the make-up of the cluster, he said.

“Is the group different in some way? Is there any reason they may not have responded to the vaccine well?” Dr Michael asked. “A large proportion of mpox has occurred in people with HIV. HIV may modify how effective the vaccine is. We don’t know the HIV status of this cluster at the moment.”

If these options are ruled out, Dr Marks said that the health authority will then assess whether there has been a mutation in the virus which has affected the effectiveness of the vaccine. 

The investigation is under way, and the French health authority told The Telegraph that it is waiting on “robust data on the real-life efficacy” of the vaccine. 

Ultimately, however, Dr Marks said there may not be a clear explanation.

“It is important to go through the steps of unpicking,” he said. “But the vaccine isn’t 100 per cent effective, and sometimes you will just see a number of cases in the vaccinated.”

What do we know about the vaccine?

There is no specific mpox vaccine; instead a smallpox vaccine is used, known as Imvanex or Jynneos. In the UK and Europe, this has been offered to people at higher risk of exposure, and those who have contact with confirmed cases.

“Although people refer to the vaccine as the mpox vaccine, it is a smallpox vaccine,” said Dr Marks. “We have historically believed that the smallpox vaccine provides good protection against mpox.”

Smallpox is in the same viral family as mpox, and its vaccine has been used successfully in previous mpox outbreaks. However, data is lacking. 

“This is the third generation vaccine, and so even our historic data comes from a different smallpox vaccine,” said Dr Marks. “There have been a number of observational studies that show the vaccine provides some but not complete protection.”

One observational UK study found 75 per cent protection after a single dose, he said. 

The French health authority told the Telegraph it is waiting for “robust data” on the “real-life efficacy of mpox vaccines”.

Current status of Europe’s outbreak

The European outbreak peaked in July 2022, with tens of thousands of cases occurring in a relatively short time period. Since then, cases have declined rapidly.

In the first two months of 2023 there was less than one case a fortnight in the UK.  “That pattern is broadly consistent across much of Europe,” said Dr Marks. 

Deaths in Europe have been low throughout the outbreak, with six reported among tens of thousands of cases over the past six months.

Nonetheless, Sante Publique France, the French health authority, warned those at risk to be vigilant as Pride season approaches.

“The cluster currently monitored in the Centre Val de Loire region calls for vigilance as the season of international MSM festivals and pride marches approaches,” it said.

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