Parents of children attending a nursery in Illinois are experiencing first-hand the “freedom of choice” so much invoked in recent years regarding vaccines. The finding of monkeypox in an educator raised the question of what to do with the dozens of people she had come into contact with. Adults were offered the Jynneos vaccine, authorized, in addition to smallpox, also against this emerging infection, but the product is not approved under 18, as obviously are the very young who attended the center.
Monkey pox: from infection to vaccine, what you need to know
by Fabio Di Todaro
Given that the vaccine can be all the more effective the earlier it is given after exposure to the virus, within an hour the Food and Drug Administration gave a special individual authorization for the administration even to these very little ones, leaving the parents the freedom of choice. But it is a freedom that puts them on the wall, since no one is currently able to provide them with reliable data on which to base their decision: vaccinating their children with a product never tested in that age group or risking waiting for the possible appearance of monkeypox, which could be very dangerous in children?
Young people are also affected with Covid, but vaccines have arrived
Two and a half years of pandemic should have accustomed us to navigate uncertainty, but with Covid-19 no one has ever found himself in this situation: initially it seemed that the disease completely spared the youngest, protected by the timely closure of schools; when it became clear that they too, albeit more rarely than the elderly, could suffer acutely and chronically from the infection, we already had safe vaccines available, tested according to all criteria in controlled studies, whose advantages and limits we knew. In Europe, children under 5 are still exposed, and this worries us, but always with the awareness that serious and fatal cases in this age group are not frequent.
US declares a national health emergency for monkeypox
by Fabio Di Todaro
With monkeypox it is just the opposite. The disease, which can be trivial or very painful in adults, has however caused very few victims outside Africa. Widespread for now in a very large majority in men who have sex with other men, we have not yet had the opportunity to verify if in children it manifests itself with the same gravity that is seen in the African continent, where it has spread for decades, ignored by rich countries. .
In Africa, 90% of cases among children and adolescents
In central Africa, in particular, monkeypox affected 90% of children and adolescents, one in ten of whom did not survive the disease, due to encephalitis, sepsis or airway obstruction due to massive enlargement of the lymph nodes, while others remained blind due to the lesions on the cornea. Already at the end of the last decade, however, already in Africa the virus seemed to have changed “behavior”: a study published in Lancet Infectious Disease in 2019 it showed how, in the epidemic of the previous two years in Nigeria, the infection had passed from rural to urban areas, and from a prevalence in the pediatric population to focus more on young adults, with genital lesions in 70% of cases.
Monkeypox, because it must be a warning to everyone
by Maurizio Ferri
Data on pediatric symptoms today are lacking, as the Centers for Disease Control in Atlanta admits, which points out the danger of the infection for people with immunocompromised or skin conditions such as eczema. But on the other hand, there is also a lack of data with which we can reassure parents who intend to vaccinate their children against Covid-19. In the case of the Jynneos vaccine, no pediatric trials have been conducted, and even for adults they are mostly based on studies that, on small samples, seem to rule out serious reactions. The efficacy is deduced from studies on non-human primates or from the increase in the blood of antibodies against smallpox which in the laboratory also neutralize that of monkeys. We are not certain about the ongoing epidemic, for which observation is starting only now, to identify the different evolution of subjects equally exposed to the virus, vaccinated or not.
Freedom is a precious commodity, exercising it is not always easy.