Congo expects first delivery of mpox vaccine doses on Thursday

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

Congo is the epicentre of an mpox outbreak that the World Health Organisation 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 Sept. 5 and a second one on Sept. 7," response chief Cris Kacita told Reuters in a WhatsApp message, without giving further details on the number of doses or the provider.

The vaccine doses' arrival 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 United States. Washington and

Brussels 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 Congo hoped to start the first wave of vaccination on Oct. 8, but that this would depend on it receiving vaccines this week.

Health authorities face a steep challenge launching the vital campaign across a tropical country the size of western Europe. The doses must be kept at -90 degrees Celsius (-130°F) 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 around 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 have the capacity to store the doses at the required temperature.

The World Health Organisation’s acting director of epidemic and pandemic prevention, Maria Van Kerkhove, said this was the agency’s key focus as it supported Congo’s response.

“We have to look at the communication around who will get them [the vaccines] first,” she said, warning that disinformation around the vaccines was “pretty rampant”.

Dose numbers are still limited, she said, so at first vaccinations will 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 recommends its use in outbreaks for children when the benefits outweigh the risks, and this is currently under discussion in Congo.

Flu-like symptoms

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 Congo by Aug. 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 working in Congo's response who asked not to be identified as the doctor was not authorised to speak to the media.

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.

The WHO’s Van Kerkhove said some areas in Congo have 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 of mpox 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, Congo’s health minister Roger Kamba said handwashing and disinfecting furniture were also important to stop the spread of mpox.