The Community of Madrid requests permission from Health to divide each monkeypox vaccine into five doses

Spain surpassed this Tuesday the 5,000 cases of monkeypox. In total, 5,162 people have been infected, most of them in Madrid, where 1,817 have contracted the virus. The region has received “only 1,835”, according to the ministry, of which 1,504 have been inoculated since the vaccination campaign began two weeks ago. A campaign that began without promoting it at the Community Vaccination Center with 100 doses a day, and that yesterday, with 300 doses in the fridge, has been transferred to the Isabel Zendal Nursing Hospital.

The Ministry of Health has received a total of 5,300 doses through the European Health Emergency Preparedness and Response Authority (HERA). Waiting to receive 7,200 more doses, which will arrive in Spain in the coming days, the department headed by Carolina Darias rules out the unilateral purchase of new serums.

“[La consejería de] Health has been demanding a sufficient supply from the central government since May to protect the population at risk, ”they indicate from the Community. Specifically, the counselor for the branch, Enrique Ruíz Escudero, has been stating for weeks that some 6,000 doses would be needed for an effective vaccination campaign. Now, they are asking the ministry and the Spanish Agency for Medicines and Health Products for “authorization to immunize five people with each monkeypox vaccine.” “This system has been assessed and approved by the United States Food and Drug Administration (FDA)”, they justify.

“What was approved in the US, and where the Community of Madrid is going,” explains epidemiologist Mario Fontán, “is to administer the vaccine intradermally (at a shallower depth), which requires fewer doses, so it can increase the number of people you can vaccinate from one vial.” The US agency bases this decision, the expert points out, on a 2015 article in which it was indicated that “the immune response using this route of administration was not inferior to the standard route”, while “adverse effects of a local type, such as the pain or the redness, were somewhat superior”.

In any case, the one in charge of evaluating the available evidence will be the Vaccine Conference and the Ministry of Health. “It will be necessary to take into account the number of doses available, other studies, etc.”, Fontán points out, asking “to analyze everything together”. “If it were finally approved because it is considered that the effect on the immune system is similar, this would serve to be able to vaccinate more people with the same number of vials.”

Vaccination against monkeypox as pre-exposure prophylaxis, that is before contact, “is indicated as a priority for a specific population group”. This is, “people aged 18 to 45 who engage in high-risk sexual practices and who meet the established indication criteria.” The Community has opted for a self-appointment system, in which it is the citizens themselves who consider that they are in this group who ask for an appointment, which is not always easy to achieve, since the enabled web page opens the agenda once up to date.