Les autorites sanitaires ont largement maintenu en l’etat lundi leurs recommandations en matiere de vaccination contre le mpox, n’elargissant pas le vaccin a de nouvelles categories de population mais suggerant une dose de rappel aux personnes deja jugees a risque.
La Haute autorite de sante (HAS) « considere que les cibles de cette vaccination restent inchangees depuis ses precedentes recommandations », indique-t-elle dans un communique accompagnant des recommandations actualisees sur le sujet.
The HAS was contacted this summer by the Ministry of Health in a context where MPOX, formerly known as "monkey pox", is once again the subject of international concern, two years after the global epidemic of 2022.
There are currently several outbreaks underway in central Africa, including the Democratic Republic of Congo, fueled by a different version of the strain that caused the 2022 outbreak.
This was caused by "clade 2", which is still circulating quietly in many countries, including France. The epidemics in the DRC are caused by "clade 1", which has caused hundreds of deaths among children.
But the situation is complicated by the fact that a new version of clade 1, variant 1b, has appeared in the DRC and seems to circulate mainly between adults during sexual contact, as was already the case in the 2022 epidemic.
Dans ce contexte, la question se posait d’un elargissement de la vaccination preventive au-dela des publics deja cibles depuis deux ans: ils incluent essentiellement les hommes ayant des relations homosexuelles, les prostitues hommes ou femmes et toute personne travaillant dans des lieux dedies aux rencontres sexuelles.
La HAS n’a finalement pas juge necessaire d’aller au-dela, constatant que « le mode de transmission par contact intime/sexuel est majoritairement observe quel que soit le clade ». Elle continue, par ailleurs, a recommander une vaccination dite reactive aux cas contact, idealement moins de quatre jours apres l’exposition.
The health authority has, however, updated some points. It now recommends a booster dose for people in risk categories.
This recommendation is valid regardless of the person's vaccination schedule – one, two or three doses already taken – but on condition that the last dose dates back more than two years.
Finally, the HAS does not recommend a vaccine for people who caught MPOX during the 2022 epidemic, judging their natural immunity to be already sufficient.
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