As an unprecedented global outbreak of monkeypox continues to grow, Canada remains tight-lipped about its vaccine stockpile, even as advocates and medical experts warn the country may not have enough supplies to meet demand current, as many Canadians are offered only one round of what is normally a dose. fired to stretch supplies.
Countries are also rapidly acquiring more shipments of vaccines as a key manufacturer struggles to keep up with global orders to stop the spread of a virus that has infected more than 14,000 people worldwide in what year is it
“Every effort must be made to contain this infection,” Dr. Rosamund Lewis, the World Health Organization’s technical lead for monkeypox, told CBC News.
To date, more than 600 cases of monkeypox virus, or MPXV, have been identified in Canada.
An often painful and long-lasting disease that remains contagious until lesions are completely healed, the current outbreak of MPXV overwhelmingly affects men who have sex with men, although the virus is usually known to infect people wider, including women and children.
Decades after the end of widespread smallpox vaccination, which also offered cross-protection against the virus, there is now a “large pool of susceptible people around the world,” Lewis said.
So will you get enough protection in time to stop these outbreaks and prevent MPXV from taking hold? Some medical experts are hopeful, but given concerns about vaccine supplies as cases continue to rise in Canada and around the world, others aren’t so sure this virus will be contained.
High early adoption in vaccine rollout
As MPXV cases increased in Canada in recent weeks, so did the number of vaccines being offered.
In major cities in Ontario and Quebec, which have experienced about 90 percent of the country’s monkeypox cases, more than 20,000 shots have been distributed so far.
A frontline doctor in Toronto told CBC News that while new patients with the virus continue to seek treatment, demand for vaccinations is starting to wane.
“We had excellent uptake, right at the beginning of the vaccine launch in May and June, but we need to continue to scale it up,” said Dr. Darrell Tan, an infectious disease specialist at St. Michael that he is currently dealing with. about 10 patients with MPXV.
It is too early to say whether cases will stabilize and for now the vaccine supply appears to be limited, he said, adding that it would be “devastating” if these outbreaks are not contained and the virus becomes established over the long term. within sexual networks.
It is too early to say whether MPXV cases will stabilize, and for now the vaccine supply appears to be limited, said Dr. Darrell Tan, an infectious disease specialist at St. Michael from Toronto. (Lauren Pelley/CBC News)
In BC, where there are now 40 confirmed cases and counting, vaccines are being distributed at men’s health clinics and bathrooms in Vancouver. There, local officials warned that demand already far exceeds the supply provided through the federal stockpile.
“We have big outbreaks that happen Toronto yen Montrealand so they’ve requested large amounts of vaccines,” Dr. Mark Lysyshyn, assistant medical director of health at Vancouver Coastal Health, he told CBC News in mid-July. “We have a smaller outbreak here, but we want to avoid getting into the situation they’re seeing there.”
On the East Coast, no MPXV infections are known. But with cases popping up in more Canadian cities and provinces, away from the original hotspots — including 12 in Alberta and two in Saskatchewan — Halifax resident David Gosine wanted to get vaccinated before the virus spread to his city. He also assumed he might get shot locally.
“But it was much more difficult than that,” he said.
Gosine tried a local travel clinic, a sexual health center and her family doctor. No one could get a dose of Imvamune. Instead, he flew to Montreal for a nine-hour layover just to visit a vaccination clinic, gaining eligibility for the shot. under Quebec rulesas he intends to travel back for the city’s Pride festival in early August.
“I wonder why we’re not being proactive in public health on the East Coast and other parts of Canada that are considered, in the larger scheme of things in Canada, to be rural?” he asked.
‘Limited supply’ behind Ontario’s 1-dose approach
While some regions of the country may have limited access to vaccines so far, those distributing the most vaccinations are also using them sparingly.
The vaccine on offer is Imvamune, from Danish vaccine developer Bavarian Nordic. Health Canada first approved the vaccine in 2013 for immunization against smallpox, a virus long eradicated globally through widespread vaccination campaigns, in the event of a future public health emergency.
Seven years later, Health Canada extended approval of the monkeypox vaccine as well.
Imvamune is usually a two-dose injection, 28 days apart, with the option of a booster two years later.
But in guidance for health professionals released in mid-JuneOntario said it would use a “ring vaccination approach” and offer only a single dose in areas with confirmed cases, given the “limited current supply” of vaccines.
The province is not looking to expand its vaccination strategy, said Dr. Kieran Moore, Ontario’s chief medical officer of health. he said earlier this monthand adds that the strategy “seems to be working”.
“We are reviewing whether we should go back to those … individuals and provide a second dose,” he said at the time.
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Dr. Réjean Thomas, a family physician at l’Actuel, a sexual health center in Montreal, worries that a similar approach in his area could put people at risk if they are exposed to the virus, as it moves away of normal dosing schedule.
“Because of this delay in vaccines, we are giving a dose,” he said. “So what will happen to the effectiveness of the vaccine? We are concerned.”
However, the company itself is not dissuading countries from adopting a single-dose approach for now while supplies are tight. In an interview with ScienceNordic Bavarian CEO Paul Chaplin, an immunologist, said the immune memory is strong enough after a single injection that even a booster given two years later leads to the same immune response you’d see in the vaccination schedule standard.
University of Manitoba virologist Jason Kindrachuk agreed that the data presented so far show a robust immune response even after one dose.
“Because a single dose will provide greater coverage at a time of supply constraints, there is reason for this plan,” he said in an email.
Canada’s vaccine advisory body, the National Advisory Committee on Immunization (NACI), suggests that people can be offered a vaccine after exposure to MPXV, while a second dose “may be offered” after 28 days if an assessment indicates a foreseeable and continuing risk. of exposure
But in the guidelines issued for pre-exposure vaccination, which focuses only on people at high risk of “occupational exposure in a laboratory research setting,” NACI recommends that Imvamune can be offered and given in two doses.
No deliveries are expected until 2023
Canada’s vaccination efforts so far suggest a swift response to this emerging crisis, although it could be hampered by limited supplies if cases continue to rise in more parts of the country.
In an email to the Public Health Agency of Canada (PHAC), CBC News asked how many doses of MPXV vaccine have been delivered and received by the provinces; how many doses have been ordered; and whether a single-dose approach is being used across Canada.
However, Health Canada and PHAC spokesman Mark Johnson did not provide specific details, including the number of doses ordered, delivered or received.
“PHAC does not disclose details of National Emergency Strategic Stockpile medical countermeasures, including types or quantities, due to security and confidentiality implications and requirements,” he wrote.
Bavarian Nordic noted in a June news that PHAC was buying an undisclosed number of doses of Imvamune under a five-year contract worth approximately US$56 million, or C$72 million.
Deliveries are not expected to begin until 2023, just over five months away.
CBC News also asked federal Climate and Environment Minister Steven Guilbeault questions about vaccination efforts during a funding announcement Thursday, where he outlined support for community organizations to address MPXV.
“Some people get a second dose of the vaccine, immunosuppressed people, but we are working hard to acquire more vaccines and we are confident that we will have enough vaccines to meet the demand to deal with this outbreak,” he said.
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“Expect major shortages”
In the US, however, officials say demand for MPXV shots already outstrips the country’s supply. That country is now asking for millions of doses; so are several European countries.
“In this unprecedented situation, [Bavarian Nordic] is making every possible effort to ensure sufficient availability of vaccines to meet current demand.” the company said on July 18.
While there may be delays in vaccination, Dr. Anu Hazra, director of the Infectious Disease Fellowship Program at the University of Chicago, said it’s important to remember that the world doesn’t have to wait for vaccine development in this case.
“If we can have a…