the slow and opaque nature of the monkeypox vaccination campaign worries the target audience

“Slots are going as fast as Lady Gaga concert tickets!” At the end of the line, the coordinator in charge of prevention for the association Act-Up Paris, Marc-Antoine Bartoli, is ironic but does not hide his concern: despite the sharp increase in the number of cases of monkeypox in France (however, the health authorities and associations interviewed in this article favor the English term of monkeypox), finding a vaccination niche is an obstacle course. According to the latest figures communicated on July 12 by Public Health France (SPF), 912 cases have been confirmed in the country.

>> Monkey pox: eligible populations, waiting times, injection methods… Five questions about vaccination

Until then reserved for adults who had risky contact with a patient, vaccination against monkeypox was opened on Friday July 8 to the entire population most at risk of contracting the disease. “The first cases occurred in France in a fairly well-defined population: MSM [les hommes qui ont des rapports sexuels avec d’autres hommes] who have multiple partnersdetails with franceinfo Elisabeth Bouvet, president of the technical commission for vaccinations within the High Authority for Health (HAS).

The body has therefore chosen to open preventive vaccination against the disease to MSM as well as to “trans people, [dans les deux cas] multi-partners, (to) people in a situation of prostitution, (as well as to) professionals working in places of sexual consumption”.

Since that date, the vaccination campaign has had a sluggish start, despite a certain enthusiasm within the population concerned. “We observed the opening of the slots on the Monday that followed, and it was hell: impossible to make an appointment. The general direction of health (DGS) promised us that the situation would improve the week July 18, but it really didn’t work out”ensures the prevention coordinator of Act-Up Paris.

“The slots were quickly saturated, for lack of available doses”, confirms Marc Dixneuf. The director general of the Aides association, which works to relay the latest information on the disease, in particular via social networks, also points to the lack of consistency in information concerning vaccination. “It varies greatly from one region to another. Some regional health agencies (ARS) communicate on their website the list of places that offer vaccination against monkeypoxwhen others are content to refer to the Sida info service platform”he laments.

If the vast majority (569) of the 912 cases identified on July 12 by Public Health France concern the Ile-de-France region, the information is indeed struggling to circulate in other parts of the territory. “There are great difficulties in obtaining appointments from the target audience”, confirms Michèle Rubirola, first deputy in charge of health at the town hall of Marseille (Bouches-du-Rhône), where only the IHU Méditerranée is authorized to vaccinate against the disease. A second center should take part in the campaign in the coming days, “but staff have still not received the necessary doses and are already overwhelmed with requests”adds Michèle Rubirola, who deplores her difficulty “to get the numbers” upcoming deliveries.

To overcome the difficulties, the Aides association created a discussion group dedicated to monkeypox on Telegram messaging to help those affected to share their experience with vaccination or symptoms of the disease. Whether monkeypox often manifests itself in mild forms, some patients report terrible suffering which prompts those concerned to exercise the greatest caution while waiting to obtain the precious vaccine.

Michael knows something about it. Contaminated after a stay in Madrid at the beginning of July, this Parisian is going through an ordeal. I have never experienced such pain in my entire life.”blows the forties, who ended up being prescribed tramadol (a powerful analgesic from the opioid family) to relieve his anal pain.

“It’s like an internal burn that I can’t explain. For almost ten days, just sitting down has been complicated.”

In order to protect his partner who has not contracted the disease, Mickael multiplies the precautions. “I sleep on the sofa, and he in the bedroom. We are careful not to share the same cutlery, I systematically disinfect the toilets as soon as I go there, we avoid physical contact… All of this is a bit frustrating , but if three weeks of precautions can save him the same symptoms as me, it will have been really worth it”, he explains. In a WhatsApp group that brings together around twenty of his friendsthe subject of monkeypox and vaccination “comes back every day”. “Friends can’t find an appointment before the end of August: given the spread of the disease, it could really be complicated”worries Michael.

Could the chaotic beginnings of the vaccination campaign be put down to a lack of vaccine doses? It’s hard to get to the bottom of it. Heard on July 13 by the Senate’s Social Affairs Committee, the assistant to the deputy director of the DGS, Clément Lazarus, invoked defense secrecy to justify his silence on the subject. Part of the stock of smallpox vaccine used against monkeypox was actually formed by “the secretariat of defense and national security and therefore the secret belongs to it”justified the manager, as reported by the Public Senate channel.

The president of the technical commission for vaccinations at HAS explains that she does not have more information on the number of doses available and specifies that the extension of the campaign recommended by the High Authority “depends on sufficient availability” of these.

Contacted by franceinfo, Clément Lazarus did not respond to our interview requests. However, he communicated to senators the number of doses delivered to the field: 7,500 for the week of July 13, and an additional 5,000 planned for the following two weeks. First deliveries which are far from the mark, annoys the general manager of Aides, who estimates the population concerned by this vaccination at 150,000 people. “making a very conservative estimate”.

Head of the infectious diseases department at the Saint-Louis et Lariboisière hospital in Paris, where he vaccinates against monkeypoxJean-Michel Molina says “understanding frustration” associations. This specialist, however, claims to have “so far received all doses requested”and calls for “patience” : Despite the difficult context, with the holiday period, the seventh wave of Covid-19 contamination and the lack of staff in the public hospital, the mobilization of caregivers is remarkable in providing rapid access to vaccination to the greatest number of people”.

“We organized overnight to be able to vaccinate against monkeypox in the hospital and since then we have been gradually increasing in capacity.”

Jean-Michel Molina, head of the infectious diseases department at Saint-Louis and Lariboisière hospital

at franceinfo

As for the associations, which do not necessarily share this optimism, we are above all calling for greater transparency on the progress of the vaccination campaign on the part of the health authorities. “That there are organizational difficulties, everyone can understand that, but it still has to be said officially”insists Marc Dixneuf.

Marc-Antoine Bartoli fears for his part that these stammering beginnings are paid for in a number of contaminations. “There is a risk of paying a high price for this delay in ignition at the start of the school year: most patients need to receive two doses spaced 28 days apart and are only optimally protected two weeks after the second injection. today will not be immune until September”recalls the prevention coordinator of Act-Up Paris, who fears to see the curve of contaminations climb in the coming weeks.

To the point of extending to populations other than the target of vaccination? “The majority of multipartner MSM are on PrEP [un traitement préventif contre le VIH]which requires monitoring of sexually transmitted diseases and infections, which goes hand in hand with good care from monkeypoxexplains the association manager. “I dare not imagine what can happen if the virus ends up spreading to the general population, where this follow-up is less good, in addition to Covid-19”.

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