The government of Japan is preparing to send donations of mpox vaccines to the Democratic Republic of Congo (DRC), the epicentre of the global outbreak, according to the Africa Centre for Disease Control and Prevention (Africa CDC).

The Japan-based KM Biologics makes LC16, the only mpox vaccine currently licensed for children. This is essential for Africa up to 60% of cases in the DRC and 43% in neighbouring Burundi are children under 10.

Most of the children infected in the eastern DRC are malnourished, which means that their immune systems are weak and susceptible to mpox infection.

Vaccine donations are also underway from the European Union (215,000 doses), the US (15,000) and Gavi (5,000), and the first vaccines expected to land on the continent next week, Africa CDC Director-General Dr Jean Kaseya told a media briefing on Tuesday. 

Bavarian Nordic’s Jynneos (also called MVA-BN), is the other vaccine expected. This is not yet licensed for use in children but the company said it had recently submitted clinical data to the European Medicines Agency “to potentially support the use of the mpox vaccine in adolescents (12–17-year-olds)”. 

This follows a clinical study involving over 300 adolescents completed with the US National Institute of Allergy and Infectious Diseases (NIAID).

“Furthermore, through a collaboration with the Coalition for Epidemic Preparedness Innovations (CEPI), the company will shortly initiate a clinical trial to assess the immunogenicity and safety of MVA-BN in children from 2-12 years of age, aiming to further extend the indication of the vaccine into younger populations,” the company added.

Bavarian Nordic confirmed that it was working on tech transfer to enable African manufacturers to make the vaccine, which Kaseya told the briefing would involve the end process of “fit and finish”.

The African Union has made $10 million available to address the outbreak, and this is being used to prepare countries to receive and distribute the vaccines and improve surveillance, said Kaseya.

Gabon reports first case

Meanwhile, Gabon is the latest country to report an mpox case as cases continue to rise on the continent – up almost 2000 to 22,863 cases since last week.

However, Kaseya said that the Africa CDC was concerned that this was an undercount given weaknesses in surveillance, with some countries only able to test around 18% of suspected cases.

To address this, Africa CDC is deploying 72 epidemiologists to the outbreak hotspots to enhance surveillance and data quality.

Kaseya also confirmed that the Africa CDC had met close to 200 partners to galvanise support for mpox response, and had been assured via a foreign ministers’ forum that Western countries would not impose a travel ban on people from outbreak areas.

Kaseya also said that Gavi and UNICEF had been given the go-ahead from the World Health Organization (WHO) to procure vaccines for the continent even though the outcome of the WHO’s emergency use listing (EUL) of the two mpox vaccines was only expected in mid-September.

The EUL procedure fast-tracks unlicensed medical products in public health emergencies. As the vaccines are already licensed in the US and European Union so the EUL is likely to be issued.

The WHO has been criticised for being too slow to evaluate potential mpox vaccines already approved by the US and Europe, thus leaving Africa dependent on donated vaccines.

“Currently, we are putting all African countries’ efforts in one basket. This is why we say we are finalizing the response plan, and we have a meeting in September where countries will also pledge funding [for the outbreak],” said Kaseya.

Image Credits: Tessa Davis/Twitter .