The Access and Allocation Mechanism (AAM) for mpox has allocated an initial 899,000 vaccine doses to nine African countries severely impacted by the ongoing mpox outbreak. This distribution, made in collaboration with affected nations and donors, aims to ensure effective and equitable use of limited vaccine supplies in the effort to control the outbreak.
The allocation was approved by the AAM principals, including the Africa Centres for Disease Control and Prevention (Africa CDC), the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, UNICEF, and the World Health Organization (WHO), based on the recommendations of the independent Technical Review Committee of the Continental Incident Management Support Team for mpox. The decision was guided by epidemiological data and the readiness of the countries involved.
The nine countries receiving the initial doses are: the Central African Republic, Côte d’Ivoire, the Democratic Republic of the Congo (DRC), Kenya, Liberia, Nigeria, Rwanda, South Africa, and Uganda. The DRC, as the most affected country, will receive the largest share—85% of the total allocation—due to the fact that it has reported four out of every five confirmed cases of mpox in Africa this year.
These doses come from several international contributors, including Canada, Gavi, the Vaccine Alliance, the European Union (with contributions from Austria, Belgium, Croatia, Cyprus, France, Germany, Luxembourg, Malta, the Netherlands, Poland, Portugal, and Spain), the European Union Health Emergency Response Authority, and the United States.
Mpox, particularly the clade Ib strain, has caused significant concern, with the outbreak in the DRC and neighboring countries being declared a public health emergency of international concern by the WHO and a continental security emergency by Africa CDC in mid-August. This year, 19 African countries have reported mpox cases, with the DRC remaining the epicenter. Over 38,000 suspected cases and more than 1,000 deaths have been reported so far.
Vaccination is a key part of the response strategy, alongside timely testing, effective clinical care, infection prevention, and community engagement. Vaccines are recommended to help reduce transmission and control the spread of the disease.
Limited vaccination efforts have already begun in the DRC and Rwanda, and this allocation represents a significant step toward a coordinated and targeted vaccine deployment to curb the mpox outbreaks.
The vaccination rollout in many of the affected countries will be a new initiative, requiring additional resources. The partners of the Mpox AAM, established last month, are working to scale up the response, with more vaccine allocations expected later this year.
Key Points on Vaccine Availability and Strategy:
- Vaccine Supply: Over 5.85 million doses are expected to be available to the Mpox Vaccines AAM by the end of 2024, including the 899,000 allocated doses. These include donations of MVA-BN vaccines from the European Union, the United States, and Canada, as well as additional doses from Gavi and UNICEF.
- Vaccination Phases:
- Phase 1: Stop Outbreaks: Targeted vaccination of high-risk individuals, including contacts of confirmed cases, healthcare workers, and at-risk populations, to interrupt transmission.
- Phase 2: Expand Protection: Expand vaccination efforts to protect more people at risk as additional doses become available, focusing on areas with high incidence rates.
- Phase 3: Future Protection: Building population immunity to prevent future outbreaks.
- Target for Phase 1: Approximately 1.4 million people at risk of infection will be vaccinated by the end of 2024, with an initial allocation of 2.8 million doses of MVA-BN.
- Phase 2 Demand: Demand forecasts suggest the need to vaccinate at least 10 million additional individuals in Africa, focusing on high-risk groups, based on current epidemiological data.
- Regulatory and Policy Updates: WHO’s Strategic Advisory Group of Experts (SAGE) recommends the off-label use of vaccines for children and pregnant women in outbreak settings. Expedited regulatory approval and strengthened delivery support are critical to ensuring timely access to vaccines.
This approach underscores the importance of strategic, targeted vaccination to reduce transmission and protect the most vulnerable populations from mpox.
