The Ministry of Health with a statement of 20 October (the same that for lack of clarity seems to have been written by the “internal enemy” of the new government) announced that the negotiation of a memorandum of understanding is underway which would allow the country, as part of a research project, he receives 25,000 doses of monkeypox vaccines. On the same day, Dr Fernando Ruiz responded by launching an attack on the current Minister of Health for the delay in purchasing this type of vaccine, which is so much needed today (he forgot to mention this, as the Duque government’s Minister of Health , was criticized for delaying the negotiation and purchase of COVID-19 vaccines).
There are few monkeypox vaccines and their production is insufficient to meet international demand. The only FDA-approved vaccine in the United States is the JYNNEOS vaccine from Danish company Bavarian Nordic, with an estimated annual production of about 35 million doses, an offering that would allow approximately 17.5 million people to be vaccinated given that its effectiveness requires two doses. For this reason, and although the company initially expanded its plant and intended to increase production at its plant, in August last year it decided to seek alliances to establish production facilities for its vaccine in several countries.
Regarding the acquisition of vaccines, the current Ministry of Health today takes a position contrary to that taken by the Ministry of Dr. Ruiz regarding the purchase of vaccines against COVID-19. In the Duque government, priority was given to bilateral “negotiation”, in which Colombia ended up accepting all the conditions of Pfizer and company. Dr. Ruiz’s Ministry of Health delayed the purchase until the vaccine bill was passed by Congress, which provided legal certainty for the companies’ affairs.
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Dr. Corcho reported the withdrawal from negotiations with the Pan American Health Organization (PAHO), which announced on August 23 through which Colombia would receive 5,600 doses. The argument with which he supported the withdrawal is in principle valid: it is not possible to accept the conditions of the indemnity clause provided for in the contract. The next step was the communiqué of 20 October which produced the reaction of the former minister.
A second smallpox vaccine is ACAM2000, approved in the United States to immunize against smallpox, but only being studied as a monkeypox vaccine under a special protocol called “extended access” or “compassionate use” (see link). This type of research is not done in traditional clinical trials because it is believed that its goal is to treat patients with serious illness or in immediate danger of death when no other treatments are available (see link).
The United States has sufficient doses of ACAM2000 to meet current global demand, but its safety and efficacy need to be investigated, as this vaccine has contraindications and side effects that in some cases severely affect the heart.
It is an opportune time for Dr. Carolina Corcho to confirm whether this ACAM2000 vaccine is mentioned in the press release of the Ministry of Health and with which it is expected to receive a donation of “25 thousand doses of vaccine against monkeypox” (ver enlacAnd). This seems to be accepted when it is said to be “within a research protocol”. Equally or more importantly, the Ministry of Health confirms whether these doses would be directed to 12,500 participants who would be recruited under the “compassionate use” research protocol of the ACAM2000 vaccine.
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The daily diagnosed cases of monkeypox are starting to decline around the world and it is known that, unlike COVID-19, not the entire population should be vaccinated unless transmission spreads to other population groups. Managing the monkeypox epidemic requires more than vaccination. It is worth assimilating the experience of the previous government, where the focus of pandemic management was vaccines and there was neglect with PRAS and non-pharmacological public health measures. It is essential to have rough estimates of the population to be vaccinated.
Even so, the lack of vaccines continues to be a reality. While countries with more resources sign contracts with Bavarian Nordic for more doses than necessary (Switzerland, with nearly 9 million inhabitants, has just signed a new contract for 100,000 doses by the end of the year), poor countries, especially Africans get, at best, access to an insufficient number of doses. The history of inequity in accessing COVID-19 vaccines repeats itself. Other Latin American countries, unlike Brazil and Chile, which have promptly negotiated and started vaccination, postpone the purchase of the minimum dose for a correct management of the emergency and adopt the strategy of pharmaceutical companies, which try to snatch the monopoly on the pharmaceutical company. Denmark who took the lead.
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