Why rich countries are hoarding smallpox vaccines

Wealthier countries are responding to the monkeypox outbreak by ordering more smallpox vaccines than they require, risking a reprise of the vaccine inequality seen during the Covid-19 pandemic.

A total of 366 confirmed monkeypox cases have been identified in the UK, and a further 275 in Spain, 209 in Portugal and 48 in the US. Rich countries are responding by “ordering more vaccines than they’ll arguably need”, said Quartz.

The vaccine attracting such interest is actually for smallpox but is estimated to provide 85% protection against monkeypox.

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The US has ordered half a million doses, on top of the 1.5 million it already had stockpiled. The vaccine’s Danish maker, Bavarian Nordic, has received so many orders that it has more than doubled its revenue projections.

Last month, Bavarian Nordic said an undisclosed country had ordered sufficient doses to cover its potentially at-risk population in the short and medium term.

The company said it was also “currently in dialogue” with several other governments concerning supply of the vaccine to mitigate the current outbreak and to “explore opportunities for longer term collaboration to build stockpiles for future preparedness”.

Despite the presence of monkeypox in Africa for decades, there has been little investment into preventing and treating cases. Therefore, said Quartz, the “best option” is to use vaccines and therapeutics developed in case of a smallpox terror attack.

Last month, Dr Luigi Ferrucci, scientific director of the National Institute on Aging, told The New York Times that older adults are partially protected by distant smallpox vaccinations.

“The bottom line is that even those that were vaccinated many decades before maintain a very, very high level of antibodies and the ability to neutralise the virus,” he said. “Even if they were vaccinated 50 years ago, that protection should still be there.”

News of smallpox jabs being hoarded by wealthier countries has reignited concern about vaccine inequality. During the Covid pandemic, the World Health Organization said that the “global failure to share vaccines equitably” was “taking its toll on some of the world’s poorest and most vulnerable people” and leading to new variants of concern that meant that the risks of infection “increased in all countries for people who are not yet protected by vaccination”.

The monkeypox virus was discovered in 1958 when outbreaks of a pox-like disease occurred in monkeys kept for research, says the UK government website’s infectious diseases portal.