Mpox vaccine to be offered to healthcare workers at highest risk and close contacts of confirmed cases

SINGAPORE: Singapore will offer the mpox vaccine to healthcare workers who are at the highest risk of exposure to the disease as well as close contacts of confirmed cases.
This was announced at a press conference on Wednesday (Sep 4) against the backdrop of growing concern about the clade 1 strain, which prompted the World Health Organization to declare mpox a global public health emergency for the second time in two years. 
The vaccine JYNNEOS – which has been used in Singapore for protection against mpox and smallpox – will be offered free to both groups.
For healthcare workers who are at the highest risk of exposure, such as those working at the National Centre for Infectious Diseases (NCID), the vaccine will offer additional protection, on top of infection control protocols and wearing protective equipment. 
As for close contacts of confirmed mpox cases, the Expert Committee on Immunisation has recommended a single dose of the vaccine within 14 days of exposure. This will be administered while they are in quarantine. 
The quarantine period is currently set at 21 days, which is the incubation period observed in Africa.
“The vaccinations are offered voluntarily and both healthcare workers and the close contacts have the discretion to decide whether to take up the offer or not,” said MOH’s director-general of health Kenneth Mak. 
Professor Mak added the vaccination policies are already in place, meaning that healthcare workers who want to get vaccinated can do so. 
Since 2019, when Singapore saw one imported case of mpox, no cases of healthcare workers being infected in Singapore as a result of looking after mpox patients have been reported, according to Prof Mak. 
“It does testify to the adequacy of our protective measures to safeguard the welfare of healthcare workers and it’s generally been … the use of personal protective equipment that actually is the key towards protecting our healthcare workers.” 
“That’s why we think that the current measures they put in place for safe care of mpox patients continue to be effective. But because clade 1 infections are still relatively new – while we think that as the evidence evolves, it may not be that much dissimilar to clade 2 – there’s still an uncertainty that warrants a greater degree of caution.” 
Mr Ong noted that out of 100 infected cases in the Democratic Republic of the Congo, about three to four die, describing it as quite a high and worrying number. Many of the infections and fatalities involve children below 15.
Although the actual statistics for developed nations like Singapore are likely to be lower, Mr Ong said the country needs to pay attention to more vulnerable groups like older people who are immunocompromised, as well as children.
“We should not resort to draconian and very disruptive measures like what we did during COVID-19. No countries are doing that now,” he added. 
“The best way is to suppress the spread of the virus, provide proper treatment to those who are infected, and have a very effective vaccine strategy.” 
As for implementing population-wide vaccination against mpox, MOH said this is not recommended for now, as the clade 1 virus is “far less transmissible” compared to respiratory viruses such as influenza or COVID-19.
In addition, given that smallpox vaccination was required in Singapore until early 1981, there will be some mpox immunity among a “significant” segment of the population, or those who are 45 years old and above, MOH noted.
“There is good evidence indicating that smallpox vaccination renders cross-protection against mpox,” it added. 
Prof Mak added that MOH also does not have any recommendations to vaccinate those who are travelling to the affected areas for now. 
“We have no recommendations to vaccinate travellers at this point in time, it is also not part of the recommendations that come out from the (World Health Organization) or any of the international health authorities at this stage,” he said. 
“Our understanding is that beyond … that one case reported in Thailand and Sweden, there are no documented cases that have been picked up in any other geographic setting, beyond the African continent,” he added. 
Singapore’s current supply of JYNNEOS is expected to be sufficient for the current vaccination strategy.
However, Dr Mak said MOH is also looking at procuring more doses when available to better strengthen Singapore’s preparedness and resilience. 
He added that MOH will continue to monitor and adjust its vaccination strategy, as the situation evolves.
Out of 100 infected cases in the Democratic Republic of the Congo, about three to four die, Mr Ong noted, describing it as quite a high and worrying number. Many of the infections and fatalities involve children below 15.
Although the actual statistics for developed nations like Singapore are likely to be lower, Mr Ong said the country needs to pay attention to more vulnerable groups like older people who are immunocompromised, as well as children.
“We should not resort to draconian and very disruptive measures like what we did during COVID-19. No countries are doing that now,” he added. 
“The best way is to suppress the spread of the virus, provide proper treatment to those who are infected, and have a very effective vaccine strategy.”