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Monkeypox cases rise to 126 as new advice on vaccines could increase doses fivefold

14 cases have been confirmed since the previous weekly report.

LAST UPDATE | 25 Aug 2022

14 NEW CASES of monkeypox have been recorded in the HSE’s weekly report on the virus, bringing the total number of cases in Ireland to 126.

The report notes that 11 cases have been hospitalised: five cases were admitted for clinical care related to monkeypox, two admitted for isolation purposes only, and information on the reason for admission for the other four is still awaited.

New advice on monkeypox vaccines could allow for the number of available doses to increase by five times, according to Minister for Health Stephen Donnelly.

The National Immunisation Advisory Committee (Niac) has issued updated guidance on the vaccine that will allow it to be administered intradermally – that is, just below the top layer of skin.

That means a smaller dose of the vaccine can be used compared to when it is given subcutaneously (deeper under the skin), allowing a higher number of vaccines to be administered overall.

In a statement, Minister for Health Stephen Donnelly said the recommendations “could provide for a fivefold increase in available doses of vaccine”.

“While anyone, regardless of their sexuality can get monkeypox, surveillance data indicates that almost all cases in Ireland are in men who self-identify as gay, bisexual or other men who have sex with men,” Donnelly said.

“I have had several meetings with stakeholders and representatives of this community over the course of the summer and I will continue to work with my Department and the HSE to facilitate this helpful, open engagement.”

The HSE’s new weekly report details that all cases are among men, with a median age of 36.

Niac has recommended the vaccine be administered intradermally as a two-dose regimen, with the doses given 28 days apart.

Its recommendations for intradermal use are on an interim basis while the global supply the vaccine is in short supply.

Interim Chief Medical Officer Professor Breda Smyth said the recommendations will “enable more extensive roll out of the vaccination programme”.

“The Monkeypox Strategic Advisory Group will continue to work with the HSE’s Monkeypox Crisis Management Team and the Sexual Health Clinical Leads to progress and support our vaccine programme,” Professor Smyth said.

She advised anyone with symptoms of a rash, or a fever with a rash, to visit a sexual health unit or their GP for advice.

“Self-isolate for the required period of time if you are diagnosed with a monkeypox infection or if you’re awaiting results of a test,” Professor Smyth said.

“If you’re offered the vaccine, it’s very important that you attend your appointment for the vaccine.

“The best way to protect yourself is to carry out risk reduction behaviours such as avoiding premises of high-risk, avoid high-risk events where it is difficult to avoid skin to skin contact with others and practice safe sexual behaviours.”

The European Medicines Agency (EMA) published new advice last week on using the vaccines intradermally after a data review by its emergency task force. 

A clinical trial involving around 500 adults compared intradermal or subcutaneous administration of the vaccine, with two doses given four weeks apart.

People receiving the vaccine intradermally received one-fifth of the amount given in the subcutaneous dose (0.1 ml compared to 0.5 ml).

They produced similar levels of antibodies to those who received the higher subcutaneous dose.

The data review noted that local reactions like skin redness or thickening came at a higher risk after intradermal injections and advised the injections should be given only by experienced healthcare professionals.

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