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“Nobody answers”… Despite the opening of preventive vaccination, finding a niche is impossible

Since the first cases identified at the beginning of May in the United Kingdom, the epidemic of monkeypox spreads. More than 5,000 cases have been identified worldwide by the World Health Organization, including 721 in France, according to the latest report from Public Health France. Doctors and health authorities repeat it: the cases of the last few weeks are not serious. “In Europe, they are mostly benign, and there are no reported deaths,” confirms Public Health France. “Fever, headaches and body aches” are the most common symptoms, and “lymph nodes may be swollen and painful, under the jaw, in the neck or in the fold of the groin”, details the agency. Then, quickly, the infection “may cause a blistering rash, and itching may occur.” An eruption that concentrates “rather on the face, in the anogenital area, the palms of the hands and soles of the feet, and which can be present on the trunk and the limbs”.

A disease whose repercussions, however, prompted several people who contracted it to recount their experience. The common point in these testimonies is the intense pain caused by the lesions. “I am under powerful painkillers because very painful”, confides Pinson, author and director, on Twitter, where he shared another testimony.

“It’s very… very painful, confirmed Jo on the same social network. When it hurts to scream / cry, it’s not trivial.

Vaccination finally extended

Consequence: calls to extend vaccination beyond contact cases have multiplied, on the part of doctors, associations, including Act Up-Paris, or even the Socialist Party and elected environmentalists. A call heard, since the High Authority for Health (HAS) recommended on Friday “that preventive vaccination be offered to the groups most exposed to the virus”. This has been the case since Monday. Are eligible “men who have sex with men” (MSM), “trans people who have multiple partners” or even sex workers. Is planned “a vaccination schedule consisting of two doses, spaced 28 days apart”, indicates the HAS.

In Ile-de-France, a region which concentrates 473 of the 721 confirmed cases in France, eighteen places – hospitals or free information, screening and diagnosis centers (CeGIDD) – offer vaccination, recalls the Regional Agency for Health (ARS) of Ile-de-France. In the Auvergne-Rhône-Alpes region, the second most affected with 70 cases, four CeGIDD are supposed to carry out this mission.

But… no doses, no vaccination

But if on paper, the territorial network is woven, in practice, it is another story. Slots unavailable, telephone lines ringing in the void: getting an appointment* is impossible. The ARS Auvergne-Rhône-Alpes also specifies on its site: “For logistical reasons, no center will be able to carry out preventive vaccinations before July 18”. And if the Paris region is the best endowed, supply does not follow demand. “I tried to make an appointment, despite around thirty call attempts on Monday, I could not have any contact, nor any response to my emails”, confides to 20 minutes Christophe, who fears “the multiplication of contaminations during the summer, for lack of access to the vaccine”. Ditto for Simon: “No one around me has managed to find a niche, the phones don’t pick up, emails go unanswered. At the Parisian hospital of Saint-Louis, it is indicated to have only about forty doses ”. And “priority is given to people already followed by the service”, abounds Act Up-Paris.

Jeremy was luckier. “Follow-up at Saint-Antoine hospital in Paris as part of my PrEP intake, I contacted my doctor ten days ago to find out if preventive vaccination was possible. At that time, it was not, but she was kind enough to call me on Friday, just after the opinion of the HAS, to inform me that it was now possible and that she could vaccinate on Monday, I am thus one of the first vaccinated”, rejoices the young man.

On the ground, “there is a lot of demand, so we have set up a consultation dedicated to the Hôtel-Dieu, because the reference centers at Pitié-Salpêtrière and Bichat are overwhelmed, explains to 20 minutes Professor Nicolas Dupin, dermatologist venerologist at the CeGIDD of the Hôtel-Dieu in Paris. We are going to open a vaccination center here, the one we had opened for Covid-19, but we do not know how many doses we will have”. An absence of information common to many centers taken by storm. Like 190, one of the most important sexual health centers in the capital, which indicated monday on twitter “not having doses of the famous vaccine” for the moment.

Unknown stocks and exploding demand

Why such a complicated start? “Vaccines against smallpox are strategic stocks because today it is a potentially bioterrorist agent, so we do not know the number of doses available”, indicated a few weeks ago to 20 minutes Dr. Jean-Daniel Lelièvre, head of the immunology and infectious diseases department at Henri-Mondor hospital. Stocks then “Sufficient to vaccinate contact cases”, but not necessarily for an extended strategy.

Faced with the explosion of contaminations, the demand for vaccines has logically exploded. And the offer is struggling to follow. The only laboratory to manufacture a vaccine already approved specifically against monkeypox, the Danish Bavarian Nordic has seen orders soar. Its smallpox serum, a live non-replicating 3rd generation vaccine, has been authorized in Europe since 2013, where it is marketed under the name Imvanex. And it is through the Hera health authority (created in the wake of the Covid-19 pandemic) that the EU has purchased nearly 100,000 vaccines, which must gradually be made available to the Twenty-Seven as well as Norway and Iceland.

On the side of the General Directorate of Health (DGS), it is assured, the ARS are getting organized. However, for the time being, “given the high demand, delays for making appointments and injections can be observed during the first days of the campaign”, acknowledged the DGS on Tuesday evening. ” Otherwise, the health authorities confirm that all the people concerned by the HAS indications can be vaccinated”, she assured. Normally.

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