The World Health Organization (WHO) has called for a global audit of smallpox and monkeypox vaccines, as well as fair access to them.

The World Health Organization (WHO) has called for a global audit of smallpox and monkeypox vaccines, as well as fair access to them.

According to the agency, many countries maintain emergency stockpiles that might be used in the event of extraordinary monkeypox epidemics around the world.

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The World Health Organization has asked countries with stockpiles of smallpox and monkeypox vaccines and treatments to hold talks to fairly distribute the doses where they are most needed.

To protect against future smallpox outbreaks, several countries have built up their own emergency vaccine supplies. Since 1978, smallpox, a virus related to monkeypox but more lethal, has been eradicated. However, some laboratories continue to preserve the virus for scientific purposes, prompting countries to keep vaccines on hand to ensure public health.

In the previous three weeks, almost 200 cases of monkeypox have been reported in 20 non-endemic countries, including Europe and North America, and the number of cases is growing. The World Health Organization asked countries to audit their vaccination and medicine stocks on Friday, urging them to offer equitable and needs-based distribution of such medical countermeasures in light of the rapidly changing and uncertain scenario.

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The WHO's appeal comes after it was discovered that the European Union's Health Emergency Preparedness and Response Authority, or HERA, is in talks to purchase monkeypox vaccines and treatments for the union.

There are numerous varieties of smallpox vaccines available, as well as one for monkeypox, and the WHO is eager to learn about worldwide supply.

"Some countries have a stockpile of the first generation vaccine," Sylvie Briand, WHO director of epidemic and pandemic preparedness and prevention, said during a press conference on Friday. "Because we don't know the actual quantity of doses accessible around the world, we invite governments to come to WHO and notify us about their stocks." What are the available quantities? Have they tested the potency of the vaccines? So that we can get a better knowledge of the resources that we currently have."

LC16m8 was the first-generation vaccine for smallpox eradication; Microgene and ACAM200 were the second- and third-generation smallpox vaccines, respectively; and, more recently, the Modified Vaccinia Virus Ankara, or MVA vaccine, was released.

Only the MVA vaccine, Imvanex, produced by Bavarian Nordic, has been authorised for use against monkeypox in the United States and Canada as of 2019. It only has a smallpox licence in the EU, but it's already being used off-label to prevent high-risk close contacts of monkeypox cases.

Briand also mentioned an other vaccination from the Russian Federation called VACdelta6, which is expected to be licenced this year. According to a 2018 WHO paper titled WHO Advisory Committee on Variola Virus Research, this vaccine is more efficacious and has fewer adverse effects than previous-generation vaccines.

Given the lack of smallpox cases in decades and the emergence of monkeypox in non-endemic countries, Rosamund Lewis, head of the WHO Emergencies Program's smallpox secretariat, pointed out that there is very little data on the efficiency of any of these vaccines against monkeypox. Based on findings from animal studies, Imvanex was approved for usage.

According to Lewis, the WHO is currently evaluating Bavarian Nordic's vaccine for prequalification, which would allow it to be used under licence in nations all over the world if approved. "That activity will have to pick up," she said.

She did stress, though, that it is a "novel product" that is the outcome of "decades of smallpox countermeasures research."

"As far as we know," she continued, "smallpox vaccines may protect against monkeypox." But, she said, there hasn't been a chance to test it in clinical studies to see if it works.

"There is no need for widespread immunisation," according to WHO's expert group on smallpox and monkeypox vaccinations, she said.

"Contact tracing, investigation, and isolation remain the principal strategies of control for the time being," she stated, because the monkeypox virus is spread mostly through close physical contact.

Meanwhile, she noted, all orthopoxvirus illnesses are vaccinated according to the 2013 guidelines. People who are at risk from an occupational standpoint, such as laboratory staff, health workers, frontline health workers, and first responders, may want to consider vaccination as a preventive measure.

There are still a lot of unanswered questions concerning these strange monkeypox outbreaks. According to Briand, genetic sequencing has revealed that the virus is similar to the West African monkeypox virus, which is the milder of two varieties with a fatality rate of 3 percent to 6%.

Cases in non-endemic nations are usually traced back to travel to an endemic country, and they are self-limiting. However, the majority of the recent epidemics are unrelated to travel. Briand said it's still unclear whether the epidemics sweeping Europe would be self-limiting and fade away shortly.

Meanwhile, scientists are investigating whether these outbreaks are linked to animal instances. Monkeypox is a zoonotic virus, which means it is an infectious illness that has spread from animals to humans. However, contrary to the name, it is mostly found in rodents.

The WHO is still unsure which animal species is responsible for supplying monkeypox with a home. It's collaborating with other animal health organisations to learn more about the animal reservoir and transmission routes, which are now only known to be direct contact.

Briand's advice to governments is to have open lines of contact with the public, to be aware of the dangers, and to respond appropriately and based on the situation.

"Please collaborate with WHO so that we can have a worldwide response to this event that is coordinated and ensures that countermeasures are available to everyone depending on public health needs," Briand urged.