Spain will reserve the second dose of monkeypox vaccine for immunocompromised

The monkeypox (“monkeypox”) vaccination plan provides for the administration of a single dose until the drugs become more availableexcept for immunosuppressed people, who will receive the second injection 28 days after the first to complete the recommendation.

These people, as well as pregnant women and children, will receive the normal amount of 0.5 ml of serum for each injection, while the The rest of people over the age of 18 will be injected with the reduced dose of 0.1 ml, in accordance with the recommendations approved yesterday by the Public Health Commission.

In the update to the Strategy released by the Department of Health on Tuesday, the Directors General of Public Health argue that “the availability of vaccine doses for its prevention, both currently and in the short term, is limitedbecause of the strong global demand and the difficulties of their manufacture”, since they are only developed by a single laboratory.

As the acquisition of more vaccines for our country is being negotiated, of which just over 12,000 have arrived, to which another 5,000 will be added; as the epidemic progressesthe recommendations had to be reviewed, both for pre-exposure and post-exposure prophylaxis.

Prioritize groups

The strategy follows prioritize people who engage in high-risk sexessentially but not exclusively to homosexuals and bisexuals included in the indications for HIV pre-exposure prophylaxis (PrEP) or infected with HIV followed in hospital consultation.

As a novelty, this update establishes that those who are not already vaccinated and who meet one of the following criteria will also begin to be vaccinated: have a high exchange of sexual partners (10 or more in the last year or more than three in the last 3 months), go to specific places to have group sexoh have had a sexually transmitted infection in the last month.

In addition, people at occupational risk predominate -as health personnel in specialized consultations for the management of STIs/HIV who take care of people with risky practices and laboratory personnel who handle potentially contaminated samples- or who are in charge of disinfection of surfaces in places where risky sexual relations take place, provided that other means of protection cannot be guaranteed.

Meanwhile, the post-exposure close contacts of confirmed cases prevail in vaccinationespecially those at high risk of serious disease (infant population, pregnant women and immunocompromised people), as well as health and laboratory personnel in contact with confirmed cases and who have had some impact in the use of EAR.

Second dose

From now on, one-fifth of the amount administered subcutaneously so far will be injected intradermallywith the exception of pregnant women, those under 18 and the immunocompromised, to whom the traditional model will continue to apply.

Model of the recommended vaccination is two doses with one interval of at least 28 days but, “due to the existing limitation”, the first will be administered and “the guideline will be completed until more vaccines are available”, except for immunosuppressed people, who will receive the second injection with the recommended interval.

In people with a history of smallpox vaccination”you may consider not administering the second dose”.

If the vaccine was given after the risky contact, a single dose will be given within the first 4 days of the first close contact, although it may be offered for up to 14 days. The second “it will only be offered if they meet the criteria for pre-exposure vaccination” described previously and ” the same recommendations established for this vaccination will be followed “.

new strategy

Vaccine vials are formulated as a single dose of 0.5ml, from which a maximum of 5 doses of 0.1 ml can be extracted; if the last dose extracted is less than 0.1ml, it should be discarded and will not be topped up “under any circumstances with product from another vial”.

Once thawed, the containers can be kept for 2 months between 2 and 8 ºC (in the fridge). In order to minimize possible contamination by microorganisms, once the first puncture has been made in the stopper, the vial should be at room temperature for as little time as possible and in the refrigerator for a maximum of 8 hours. If people are not vaccinated consecutively, they should also be stored in the refrigerator.

According to the protocol, “it is important that the intradermal administration is performed by nursing staff with experience or training in this administration technique.

To optimize the use of the vaccine, the use of syringes and needles minimizing dead volume is recommended; with him in order to avoid residual loss of volume in the needleit can be used to load and administer the drug.

The plan recommends reporting expected possibility of induration and erythema or change in skin color at the injection site. These local side effects are self-limiting and reversible.

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