Imvanex, Jynneos and Imvamune. The brand name is different in different parts of the world, but in practice the vaccines used against monkeypox are the same, coming from one company. The relatively small Danish biotech company Bavarian Nordic (760 employees) makes the only approved vaccine against monkey pox. Bavarian Nordic is also working on vaccines against, for example, the respiratory infection RS virus and the coronavirus. It expects to achieve a turnover of 266 million euros this year.
The vaccine is a new variant of older vaccines against smallpox. This so-called ‘third-generation vaccine’ is easier to use and has fewer side effects. Since monkeypox is a relatively harmless disease – hospital admissions have not yet been necessary in the Netherlands – it is extra important that the vaccine also has few side effects. Otherwise the cure is worse than the disease.
Louis Kroes, professor of medical microbiology at the LUMC, considers it fortunate that this new generation of vaccines was developed years ago, while there was no clear need at the time; there was little concern in the western world about monkey pox in Africa at the time.
The vaccines are fundamentally different from classic vaccines against smallpox. Kroes: “They often left scars and risk of dangerous side effects, such as high fever and serious illness. That is not a vaccine to be applied to a large number of people for a non-fatal disease.”
In the US and Canada, Bavarian Nordic’s smallpox vaccine is also officially approved for monkeypox. In Europe it is formally still used experimentally. How well it works against the spread of monkey pox has not yet been established.
Risk groups
Last week it was announced that the Ministry of Health wants to start vaccinating risk groups as soon as possible. There are now 503 cases of monkey pox identified in the Netherlands, turned out monday† Four days earlier, there were a hundred fewer, this was the fastest increase to date.
The GGD will start vaccinating a group of approximately two thousand people in Amsterdam as soon as possible. This is the same target group that is eligible for PrEP, preventive tablets against HIV. At the same time, the vaccination of a wider target group is being prepared.
Because it is actually still unclear how well the vaccine works against the spread of monkey pox, a study into its effectiveness will immediately be conducted in the Netherlands.
Also read the question: Monkeypox now also in the Netherlands. What is known about this virus?
Dutch stock
The Dutch government has had a stock of 100,000 doses of smallpox vaccine from Bavarian Nordic for several years now. This is in addition to the government’s first-generation smallpox vaccine stockpile in the event of an unexpected smallpox outbreak, or if the smallpox is being used as a biological weapon.
In the summer of 2019, the then minister Bruno Bruins (VVD, Public Health) informed the House of Representatives about the purchase of the additional stock from the Danish company. That was a few months before the Netherlands was confronted with the corona virus and resilience to a pandemic was placed on the political agenda. There had been a brief outbreak of monkeypox in the UK a year earlier. “With this purchase, the Dutch government has made its strategic stock sustainable for the coming years,” Bruins wrote.
Should the spread of the disease take off, the question is whether Bavarian Nordic can produce enough vaccines. According to The New York Times to get the US will have two million doses of the drug this year, and the company cannot produce more than five million doses for the rest of the world. There is one production location where the vaccines are made, a second will be closed in the coming months due to renovation. The Danish company becomessays an employee to Forbes“bombed” with orders† Even from countries where not a single case of monkey pox is known yet.
“I want to emphasize that it is absurd that we rely on one manufacturer as a supplier of a vaccine to contain a worldwide outbreak,” pharmacy expert Zain Rizvi told The New York Times† “It is so stupid that we are in such a situation again.”
Kroes calls it a “very good question” whether there will be enough vaccines if many countries start vaccinating widely against monkey pox. “I’m not optimistic about that. In general, it takes quite some time before additional production sites can make additional vaccines in accordance with all regulations. It is important that countries continue to look critically at how widely the vaccine is used.”