Mpox Vaccination in Africa: What Needs to Happen Next
October 1, 2024
The recent surge in mpox cases across Africa has prompted increased vaccine donations from global partners. However, vaccine availability alone is insufficient. Three key priorities emerge:
1. Targeting the right groups: Deciding between curbing outbreaks beyond DRC's borders or focusing on high-risk regions within DRC.
2. Strengthening delivery systems: Improving immunization infrastructure, from human resources to storage and transportation.
3. Building public trust: Ensuring community acceptance of vaccination efforts.
While progress has been made in securing vaccines, including Gavi's purchase agreement for 500,000 doses, the challenge lies in effectively allocating and delivering these vaccines to the most affected communities.
The recent surge in mpox cases across Africa has triggered a global response, with several governments pledging millions of vaccine donations. This effort was bolstered by the World Health Organization's prequalification of Bavarian Nordic's vaccine and Gavi's advance purchase agreement for 500,000 doses. However, experts emphasize that securing vaccines is just the first step in an effective response.
Three key priorities have been identified to translate vaccine availability into successful immunization campaigns:
1. Prioritizing populations at risk:
National leaders in affected countries face crucial decisions about vaccine allocation. They must choose between focusing on curbing outbreaks that have spread beyond the Democratic Republic of Congo's (DRC) borders (subclade Ib) or addressing the larger disease burden in high-risk regions within DRC (subclade Ia). While recent global attention has centered on subclade Ib outbreaks, the majority of cases and deaths stem from subclade Ia in endemic, rural DRC provinces. Ultimately, allocation decisions will reflect prioritized disease control targets.
2. Strengthening immunization delivery:
Ensuring vaccines reach those in need presents significant challenges. The DRC has historically struggled with immunization coverage, rarely exceeding 70% even for routine vaccines like measles. Strengthening the entire immunization delivery system—from human resources to storage and transportation—is essential. This requires sustained investment and focus, potentially leveraging support from organizations like the World Bank and UNICEF, especially in conflict-affected areas.
3. Building public trust:
While not explicitly detailed in the given text, building public trust is crucial for any vaccination campaign's success. This involves clear communication, community engagement, and addressing any misinformation or hesitancy surrounding the vaccine.
These priorities underscore the complexity of mounting an effective mpox vaccine response in Africa. While progress in vaccine procurement is encouraging, the ultimate success of the campaign will depend on strategic allocation, robust delivery systems, and strong community engagement.