Vaccination of young children could dramatically reduce mpox deaths in DRC

Vaccinating children under 5 in Mpox-endemic areas of the Democratic Republic of the Congo (DRC) could significantly reduce deaths in the country, according to a new analysis by researchers at the Yale School of Public Health. It is said that there is a sex.

The study, led by Dr. Greg Gonsalves, associate professor of epidemiology at the Yale School of Public Health (YSPH), and Alexandra Savinkina, a fourth-year doctoral student in the YSPH Department of Epidemiology (Microbial Diseases), modeled different mpox vaccinations. Consider your DRC strategies and see which ones are most effective.

Mpox is an infectious disease caused by the monkeypox virus. It was first identified in the Democratic Republic of the Congo in 1970, and an unprecedented outbreak occurred in 2023.

Health officials said the virus is now spreading at an alarming rate. In the Democratic Republic of the Congo, more than 14,000 people were infected with mpox in 2023, with more than 700 deaths, 70% of which were diagnosed in children. So far in 2024, Congolese authorities have reported more than 31,000 suspected cases and nearly 1,000 deaths. However, researchers believe that mpox is largely underreported in the Democratic Republic of the Congo, with only an estimated 41% of cases recorded, so the true total number of cases may be much higher.

On August 14, 2024, the World Health Organization declared the current mpox outbreak in the Democratic Republic of the Congo a public health emergency of international concern, the highest level of global alert.

In the Yale University study, researchers created a mathematical model to identify effective vaccination strategies against M.P.O.X. in the Democratic Republic of the Congo. The study analyzed multiple hypothetical scenarios in which the modeled vaccination strategy would have been completed before the 2023 outbreak.

This is the first analysis to consider mpox vaccination scenarios in the Democratic Republic of the Congo in light of the current epidemic. My hope is that this will inform national and possibly regional vaccination policies and move the needle forward in getting vaccines to those who need them most in the Democratic Republic of Congo. ”

Alexandra Savinkina, 4th year doctoral student, YSPH Department of Epidemiology (Microbial Diseases)

This study simulated how different vaccination campaigns could be rolled out to prevent mpox cases and deaths in the Democratic Republic of Congo. In this model, if 10.5 million vaccines were given to 80% of children under 5 in areas where the virus is endemic or endemic, the number of infections would decrease by 27% and the number of deaths would decrease by 27%. It predicted the number would have fallen by 43%. 80% of children under 5 years old vaccinated all regions This would reduce the number of infections by 29% and deaths by 43%, but would require 33.1 million doses. Vaccinating 80% of children under 15 in endemic states would reduce infections by 54% and deaths by 71%, resulting in a greater effect, but would require 26.6 million doses. It will be.

Models that take into account vaccine impact and implementation show that vaccinating children under 5 years of age in endemic areas is the most efficient and effective, providing the greatest benefit with the least number of doses. It was done. Although a vaccine for mpox is available, access to this life-saving vaccine is extremely limited in the DRC.

The modified vaccinia Ankara vaccine (trade names JYNNEOS, Imvamune, Imvanex) was widely used during the 2022 MPOX outbreak in the United States and Europe. However, these vaccines are not yet available in the Democratic Republic of Congo. The JYNNEOS vaccine is up to 87% protective in people who are not immunocompromised.

“We hope that we can learn from the global mpox outbreak that we cannot ignore diseases in other places far from our shores,” Savinkina said. “I think if there are resources out there to help people, whether it's in the United States or Africa, we should take advantage of them.”

There are also concerns about vaccine delivery in the Democratic Republic of Congo, where many regions are rural and lack a national distribution network.

“We take for granted the ability to get vaccinated at our local CVS and get a COVID-19 or flu shot,” Gonsalves said. “The infrastructure for delivering vaccines in the Democratic Republic of the Congo is much less robust.”

The Yale study had some limitations because the model considered only a single-year period in its simulations. There is also little data on the effectiveness of the mpox vaccine. It's still unclear how many years a single shot will remain effective, but health officials hope it will remain effective for decades, similar to the smallpox vaccine. This would be of great benefit in the Democratic Republic of the Congo, where it is difficult to administer multiple doses of the vaccine to isolated rural areas.

Gonsalves and Savinkina said this research will spur global action to provide the Democratic Republic of the Congo with a lifesaving vaccine to stop the current epidemic that is devastating the country, especially children. He said he hopes it will encourage them.

Other authors include Virginia E. Pitzer of YSPH, Jason Kindrachuk and Souradet Y. Shaw of the University of Manitoba, and Placide Mbala-Kingebeni of the National Institute of Biomedical Research.