9 African nations hardest affected by an MPOX outbreak will receive vaccine doses.

Access and Allocation Mechanism (AAM) for MPOX has allocated 899 000 vaccine doses across nine African nations currently experiencing high rates of MPOx epidemic. As agreed between affected countries and donors, this decision aims to ensure the limited doses available are used efficiently and fairly with an overall goal to control outbreaks. AAM principals from Africa Centers for Disease Control (Africa CDC), CEPI Coalition for Epidemic Preparedness Innovations (CEPI), Gavi (Vaccine Alliance International – The Vaccine Alliance International), UNICEF and WHO approved allocation based on recommendations made by an independent Technical Review Committee of Continental Incident Management Support Team for Mpox. Decision was taken based on country readiness and epidemiological information. Nine countries included in this decision are Central African Republic, Cote d’Ivoire, Democratic Republic of the Congo, Kenya, Liberia Nigeria Rwanda South Africa Uganda This year, 19 countries in Africa have reported measles outbreaks – many newly infected by this viral illness. Democratic Republic of the Congo remains at the epicenter of an outbreak, with over 38 000 suspected cases and 1,000 deaths recorded this year alone. As part of an effective response strategy to Mpox outbreaks, vaccination is recommended as one component. Other components may include timely testing and diagnosis; effective clinical care; infection prevention strategies and engaging affected communities as a part of any response strategy. Vaccinations play an integral part in combatting transmission and helping contain outbreaks. Over recent weeks, limited vaccination efforts have begun in Democratic Republic of the Congo and Rwanda. This allocation to 9 countries represents an important step toward an organized and targeted deployment of vaccines that could end mpox outbreaks. For many nations, rolling out of MPOX vaccines will be new undertaking; therefore additional resources may be required. Partners of the recently formed Mpox AAM are working hard to increase response. Antivirals should become available prior to December. Notes to Editors/Letter to Media Covering the Global and Continental Strategic Preparedness and Response Plans on vaccination:Availability: By 2024, approximately 5.85 million vaccine doses should have become available through Mpox Vaccines AAM for distribution; of which nearly 90000 will have already been allocated as of 2019. Phase Two (Expand Protection) – To extend protection to more people in affected communities as additional doses become available. It specifically targets high risk individuals based on local epidemiology who reside in areas with the highest incidences of MPOX disease. Special consideration will be paid to vulnerable populations such as people living with HIV, internally displaced people, and refugees due to their increased risk for severe outcomes. Phase 3 – Build Population Immunity – Phase three is designed to build population immunity against future outbreaks as part of a longer-term mpox control programme, targeting approximately 1.4 million at-risk of infection by 2024 with approximately 2.8 million doses of MVA-BN vaccine provided for this effort. To maximize vaccine’s impact through targeted vaccination approaches and reduce transmission rates while simultaneously protecting wider communities. This vaccination strategy prioritizes those at high-risk of exposure, including household members and sexual partners of confirmed cases who could come in close contact. Prevention and control interventions should be used together in order to maximize the efficacy of vaccination efforts. Demand Planning for Phase 2: Current forecasts estimate an increased vaccination need of at least 10 million individuals for high risk groups throughout Africa in Phase 2. Projections are made using current epidemiological information as well as emerging knowledge on transmission patterns. Estimates will be revised as more data becomes available and as the outbreak trajectory develops.Regulatory and policy updates: In terms of regulation and policy updates, WHO Strategic Advisory Group of Experts (SAGE) advises the off-label use of vaccines during outbreak settings for children and pregnant women, according to SAGE recommendations. Urgent action must be taken to expedite regulatory pathways for vaccine approval across affected countries, to ensure timely access for infants and children. In addition, strengthening delivery support services within countries will address in-country vaccine delivery challenges efficiently distribute supplies.