French health authorities announced Tuesday that 2,171 monkeypox cases have so far been confirmed in France, more than half of them in the Paris region. To combat this rising number, local authorities have opened the capital’s first vaccination centre dedicated entirely to administering the smallpox vaccine – which has been found to be effective against monkeypox – to targeted groups.
Located in Paris’s 13th arrondissement (district), the dedicated monkeypox vaccine centre currently consists of one waiting room with small adjoining vaccination at the Edison community health centre.
Upon entering, patients are immediately informed that they can only be vaccinated if they have reserved on Doctolib, a privately run website that many French residents use to book medical appointments. Staff at the reception desk have the patient fill out a questionnaire and verify their identities, although patients are not required to have a doctor’s prescription to be inoculated.
The French government said last week it would mobilise more people to help administer vaccines, including doctors, nurses and medical students. Once patients have been vaccinated, they will be booked in for a second appointment within 28 days, although health authorities have said this time limit may be extended.
If someone comes to the centre with monkeypox symptoms, they are immediately sent home to self-isolate for the duration of the illness, which typically lasts two to four weeks. Samuel Etien, a medical student and volunteer at the centre, recommends people consult a physician if they notice any kind of rash consisting of large hardened pimples with pus or crusts developing in the area around their mouth or the palms of their hands; pimples that often appear all at once; and mouth or anal pain. The medical student says the most common symptoms are a red rash on the anal or oral mucous membranes, a cluster of pimples, influenza-like symptoms (fever, aches) and swollen lymph nodes in the neck and armpits. Etien said confirmed or suspected cases should be isolated as soon as possible.
Serving ‘at risk’ groups Some 95 percent of French monkeypox cases have been diagnosed in men who have sex with men, and a quick glance around the waiting room confirms that most of those being inoculated on Monday were male.
The vaccine centre is currently prioritising the most at-risk populations, including gay men, trans people, those with multiple sexual partners and sex workers, with no immediate plans to open up vaccinations to the general public. In an effort to encourage sex workers to get a preventative dose of smallpox, the centre is planning to allow sex workers to make appointments through third-party associations in addition to Doctolib.
Frederique and Hervé, two gay men who acknowledged they were in the high-risk group, said they were getting the vaccine because “the illness is spreading and we’re going on holiday to Africa so we wanted to take pre-cautions”.
“This isn’t just a gay disease,” they said as they left the centre. It’s a statement echoed by Dr. Yannick Simonin, a virologist and lecturer specialising in emerging viruses at the University of Montpellier, who told Le Monde : “Anyone who has close physical contact with another person who has contracted monkeypox is at risk, regardless of sexual orientation. Monkeypox does not only concern this (homosexual) community, even though the number of cases within it is currently over-represented.”
Renaud, 50, said he got vaccinated since he is considered “a person at risk” as a gay man with multiple sexual partners. He only needed a single dose since he was vaccinated against smallpox when he was younger. While it was difficult at first to secure an appointment on Doctolib he said the government was handling the outbreak well.
Adrian, another gay man, said he has multiple sexual partners and wanted to get the vaccine so he could “have a normal life without being scared”. He expressed hope that the virus will continue to be taken seriously, as he feels the government reacted too slowly to the Covid-19 outbreak.
Anne Souyris, the deputy mayor of Paris in charge of public health, said there are plans to expand the vaccine centre “as much as possible”, adding that other venues could be opened if there are enough personnel to staff them. Through these and other measures, she hopes that “this epidemic will be contained, or at least slowed down, by the end of the summer”.
Etien said he remains “concerned”.
“The number of cases is doubling every two weeks at the moment and no similar situation of monkeypox infection has occurred in Europe to date,” he said.
“Vaccinations have started well and will continue and intensify throughout the summer and even into September. But what is missing are public information campaigns and walk-in vaccination centres, which would facilitate access for people who are isolated” or less well-informed about the risks.
He said vaccine centres had been set up quickly, likely because of previous experience with Covid.
However, he said, the vaccines are not being managed in the same way due to the secrecy surrounding smallpox, which can be a potent biological weapon. The French state keeps stocks of the vaccine in case of a biological attack.
Amélie Verdier, the head of the Paris regional health agency, told AFP on Monday that the speed of the vaccine roll-out is still hampered by a shortage of trained professionals to administer them at centres across the capital.