True or false Is the vaccination campaign against monkeypox too slow to control the epidemic, as Sandrine Rousseau asserts?

Concern is mounting within associations and among practitioners, but also among opposition politicians: the vaccination campaign against monkeypox would slip, not allowing the epidemic to be controlled. The Minister of Health, François Braun, however, wants to be reassuring: “NOTWe have vaccinated more than 30,000 people and the rate of vaccination is accelerating, with more than 2,000 vaccinations per day“, he declared Wednesday August 10 on RTL,

Far too little for Sandrine Rousseau, who reacted on Twitter after the minister’s remarks, with supporting figures: “The target, in Paris alone, is 150,000 people to be vaccinated. The longer we delay, the less the epidemic is under control..” Is MP EELV right to give the alert?

The target, in Paris alone, is 150,000 people to be vaccinated. The longer we delay, the less the epidemic is under control. https://t.co/lA2QrTZbxw

— Sandrine Rousseau (@sandrousseau) August 10, 2022

“There is a major problem of vaccine capacity” confirms Gilles Pialoux, head of the infectious and tropical diseases department at the Tenon hospital in Paris. “You have 10,000 vaccinations per week. But the target population is 250,000 people” in France, he underlines, taking up the figures of the High Authority for Health. In these conditions, “the end of vaccination will not occur before the end of the year, this is not acceptable“.

More and more people are now eligible for the vaccine: since July 8, the most exposed groups, namely “men who have sex with men and trans people who have multiple partners, people in a situation of prostitution and professionals working in places of sexual consumption”, can receive their injection.

For Gilles Pialoux, the figure of 150,000 people eligible for vaccination in the city of Paris alone, put forward by Sandrine Rousseau, seems likely. He is correlated with the large size of the MSM population (men who have sex with men) in the Paris region, one of the main populations at risk of the monkeypox virus.

How to explain such a slowness of the vaccination campaign? Practitioners already rule out certain factors. “There is no dose problem. The Ministry of Health and the General Directorate of Health reassure us on this point: France is well endowed,” relates Gilles Pialoux.

“We have no precise information on the number of doses, which is classified as a defense secret”, nuance however Yannick Simonin, virologist and teacher-researcher at Inserm at the University of Montpellier. The vaccine used against monkeypox virus (or monkeypox, in English) is indeed that of smallpox, a virus considered a biological weapon covered by military secrecy. And if no shortage has been mentioned in France, the virologist points out that at “US and UK supply issues have already been reported“.

In France, “the real problem is a problem of arms, centers and vaccination dynamics”sighs Gilles Pialoux. At Bichat hospital, infectious disease specialist Nathan Peiffer Smadja notes a lack of personnel to vaccinate. “As a hospital center for infectious diseases, we have taken this new activity of vaccination and screening for monkeypox at constant staff. Overall, a fifth of the service has been assigned to it.”

Questioned by franceinfo, Sandrine Rousseau deplores as for her “that there is only one vaccination center in Paris” while the vaccination campaign started more than a month ago. “I went to visit this center [qui ne dispose] than three vaccination booths. Only 150 people are treated there per day, which is very very low.“, regret the member. In addition to this center opened by the city of Paris, the capital has a total of 21 vaccination points, in hospitals or health centers. And according to Professor Pialoux, around 4,500 people have been vaccinated in Ile-de-France.

Another problem also raised by the MEP: the targeting of prevention campaigns that do not reach precarious populations such as “minors and male prostitution”. A shortcoming also noted by Professor Pialoux: “There is a whole population that we see little in the hospital, for example sex workers”.

Contacted by franceinfo, the Ministry of Health says it is working on an experiment with pharmacies to increase vaccination capacity. Since August 9, five pharmacies have been authorized to vaccinate their customers, according to a decree published in the Official Journal. The objective of the experiment, which should last a fortnight, aims in particular to test the logistics of an anti-smallpox vaccine which must be kept at -80°C then, once thawed, can only be kept for fifteen days in refrigerators. For its part, the Directorate General of Health (DGS), contacted by franceinfo, recalls that “France is one of the only countries in the world to have opened a preventive vaccination” and that an order issued by the Minister of Health on July 26 extended the list of people who can carry out this vaccination to retired doctors and nurses, as well as to health students, which “which should allow to further increase the number of vaccination slots open during this period summer”.

However, the government’s response does not completely convince practitioners. “We must not put everything on the hospital and the pharmacists. To increase the capacity [de vaccination]we will have to go through the vaccinodromes,” Judge Gilles Pialoux. “Pharmacists are a good alternative”, concedes the infectiologist, who however criticizes “a system ultra precaution with an experimental step that we do not need.” According to him, pharmacies already master “The cold chain” that they have put in place for RNA vaccines against Covid, “no more restrictive“than those for smallpox.

But time is precious in the fight against the pandemic. The number of patients with monkeypox remains modest compared to the total population, with 2,673 cases recorded on August 11 at the national level, according to Public Health France. After an explosion in the number of cases in the spring, the number of contaminations seems to have stabilized between 300 and 400 cases per week since the beginning of July.

However, “sif the monkeypox virus is allowed to circulate, it risks spreading more widely to the most vulnerable peoplewarns Yannick Simonin. It is therefore imperative to have a vaccination campaign as quickly as possible to avoid its spread in the general population.