DRC expects first delivery of mpox jabs on Thursday

Democratic Republic of Congo (DRC) expects to receive its first delivery of mpox vaccine doses on Thursday and a second delivery on Saturday, the head of the mpox outbreak response said on Wednesday.

DRC is the epicentre of an mpox outbreak that the World Health Organisation (WHO) declared to be a global public health emergency last month, but efforts to curb the spread of the disease have been hampered by a lack of vaccines.

“We’ll receive the first batch on September 5 and a second one on September 7,” response chief Cris Kacita told Reuters in a WhatsApp message, without giving further details on the number of doses or the provider.

The arrival of the vaccine doses would help to address a huge inequity that left African countries with no access to the two shots used in a 2022 global mpox outbreak, while they were widely available in Europe and the US. Washington and Brussels have pledged tens of thousands of doses of a vaccine made by Bavarian Nordic, and said they could be delivered soon.

Kacita said on Monday that the DRC hoped to start the first wave of vaccination on October 8, but that this would depend on it receiving vaccines this week.

Health authorities face a steep challenge launching the vital campaign across a country the size of Western Europe. The doses must be kept at -90 °C and communities can be wary of participating.

“The vaccine will not be distributed as soon as it is received,” Kacita said, explaining why it would take about a month from delivery to launch the campaign. “We need to communicate so that the population accepts the vaccination,” he said, adding that the six targeted provinces had the capacity to store the doses at the required temperature.

The WHO’s acting director of epidemic and pandemic prevention, Maria van Kerkhove, said this was the agency’s key focus as it supported the Congolese response. “We have to look at the communication around who will get them [the vaccines] first,” she said, warning that disinformation was “pretty rampant”.

Dose numbers were still limited, she said, so at first vaccinations would be focused on the contacts of known cases.

Children are at high risk from mpox, but Bavarian Nordic’s shot is not licensed for children. However, Van Kerkhove said the WHO recommended its use for children when the benefits outweighed the risks, and this was under discussion in the DRC.

Mpox typically causes flu-like symptoms and pus-filled lesions, and can kill. There were 19,710 suspected cases of mpox reported since the start of the year in the DRC by August 31, according to the health ministry. Of those, 5,041 were confirmed and 655 were fatal. It spreads through close contact, including sexual contact.

“The greatest loss of human life is in rural areas. These are remote areas where there is no support,” said a doctor, who asked not to be identified.

The doctor expressed concern that a successful campaign would depend on vaccinating those in the vicinity of confirmed positive cases, but many areas with suspected cases lacked the right resources. “We can’t have laboratories in places with no water or electricity. This is the weakness of current surveillance, the lack of capacity to check suspected cases in the laboratory,” the doctor said.

Van Kerkhove said some areas in the DRC had run out of tests, and called for more resources to support the response there as well as in neighbouring Burundi, which has also seen a rise in cases of the new clade Ib strain in recent weeks. She said vaccines were only part of the answer, and measures such as contact tracing and raising awareness of how to prevent infection were also key.

In a video message on Wednesday, focused on children returning to school, DRC health minister Roger Kamba said handwashing and disinfecting furniture were also important to stop the spread of mpox.

Reuters