Monkeypox outbreak: smallpox vaccine to be offered to high-risk groups in Ireland

Health officials are set to extend the use of the smallpox vaccine for individuals who are at high risk of contracting the monkeypox infection in Ireland.

The announcement follows recommendations made on the July 22, by the National Immunisation Advisory Committee (NIAC) to the Interim Chief Medical Officer (CMO), who has endorsed the plan.

NIAC has recommended that a pre-exposure prophylactic vaccination should be offered to those at high risk of infection, for example gay and bisexual men who have sex with men (gbMSM) and others at high risk of unprotected exposure.

It said two doses of smallpox vaccine should be administered 28 days apart to as many high-risk individuals as soon as is practicable.

Health Minister Stephen Donnelly said the recommendations represent an “important step” in the ongoing response to the monkeypox outbreak and it will help protect those who are at high risk of exposure.

“Monkeypox is usually a self-limiting illness, and most people recover within a few weeks, however the rapid spread of infection necessitates further measures beyond those currently in place. The evidence suggests this approach to targeted pre-exposure prophylaxis may be highly efficient in controlling further spread of the disease,” he said.

“The Department of Health and the HSE will now work to implement these new recommendations in relation to vaccination.”

Meanwhile, Interim Chief Medical Officer Professor Breda Smyth said: “These recommendations reflect a strengthening of measures to control disease transmission and ensures that our response to this evolving situation is informed by the best available evidence.

“I strongly encourage those with symptoms of infection to seek medical advice and follow the public health guidance.”

It comes as this week the World Health Organisation (WHO) declared monkeypox a global health emergency, signalling a greater global response to an outbreak that has spread to at least 75 countries in a few weeks.

Dr Tedros Adhanom Ghebreyesus, the WHO’s director-general, took the unprecedented step of overruling a panel of advisers to make the decision.

“We have an outbreak that has spread around the world rapidly through new modes of transmission, about which we understand too little, and which meets the criteria”, he said. However he added it was still mostly of concern to homosexual men.

“Although I am declaring a public health emergency of international concern, for the moment this is an outbreak that is concentrated among men who have sex with men, especially those with multiple sexual partners,” he said.

“That means that this is an outbreak that can be stopped with the right strategies in the right groups.” The designation of a “public health emergency of international concern” is currently only being used by the Global health body for Covid-19 and polio.

It is likely to pave the way for greater international co-operation on vaccines and research, and an increase in funding for countries battling the outbreak. Dr Tedros ignored his own expert committee after nine voted against the designation and only six in favour. It was the first time a UN health agency chief has unilaterally made such a decision without an expert recommendation.