Monkeypox has already confirmed cases in Spain, and many countries are taking measures to prevent its spread. In this context, vaccines against the “conventional” version of the infection came up again. We know that this serum has the ability to fight the disease we are fighting with some effectiveness. The problem is that since smallpox was eradicated in the 1970s, the vaccine was discontinued over the next decade. This led some to save an article published in 1988 that warned us of the risk of this happening.

What did they say in the 80s?
The article was published in the journal International Journal of Epidemiology by a team of three scientists London School of Hygiene and Tropical Medicine. The group of experts was analyzing cases of this disease in Zaire (now the Democratic Republic of Congo) during the five-year period 1980-85.

The analysis concluded that the smallpox vaccine provided 85% protection against the monkey variant. At the time of publication of the article, the disease was considered eradicated and the newborns were not administered serum. That’s why the scientists warned that “the average size and duration of monkeypox epidemics” will increase as the proportion of the vaccinated population declines.

The prophecy has come true.
WHO declared smallpox eradication in 1979, some time after observing cases. When the disease was eradicated, vaccines were no longer necessary, so in 1980 they were no longer administered to the general population (but not to laboratory personnel who were susceptible to the vaccine while working on it).

This means that elderly people are most protected against monkeypox, both in Spain and in the rest of the world. Also, the situation continues to change and will continue to change over the years as the vaccinated population grows older and smaller. Despite the lower infectivity of the monkey variant in humans, the authors conclude from all this that the emphasis on preventing the spread of the disease is control and surveillance in endemic areas, not necessarily through vaccination.

Back to the future.
If the first warnings about the possible effects of this infection in the “post-vaccine era” date back to the late 1980s, you don’t need to look far back to find the latest ones. In an article published in February of this year, an international team reviewed how the epidemiology of this disease has changed.

Reviewing several studies, the team noted an increase in the expected average age of monkeypox patients due to demographic changes and cessation of vaccination. Perhaps more alarming is one of the studies they cited, which predicted through mathematical models that the monkey’s R0 factor could exceed 1 with low immunization levels.

without excluding epidemics.
This means that the virus has the capacity to cause epidemics, but as the Covid pandemic has taught us, the ease of transmission of a disease depends on many factors and calculations must be constantly adjusted. For all this, it is not surprising that the authors of this new study agreed to recommend control and surveillance of a disease that would not cause the havoc caused by smallpox, but it is not without risk.

Vaccination begins.
Spanish authorities have already recommended the purchase of a number of vaccines to vaccinate close contacts of infected people. Not the only country stockpiling doses to tackle this new threat, the UK has recently made these serums available to healthcare professionals. The United States has already purchased millions of units after detecting the first case in Massachusetts. One advantage of these vaccines is that they can be beneficial even for people who have been exposed to the disease before.

Image | Shut Up Naidoo Jade Photography