Post-Exposure Vaccination: A Vital Tool in Sierra Leone’s Mpox Battle

As Sierra Leone grapples with a concerning surge in Mpox cases, health authorities are increasingly looking towards vaccination as a critical tool to not only save lives but also to curb the escalating spread of the virus. While pre-exposure vaccination targets high-risk groups to prevent infection, post-exposure prophylaxis (PEP), the vaccination of individuals after they have been exposed to a confirmed case, is emerging as a crucial intervention to limit the outbreak. Will the central government’s Ministry of Health take this approach seriously and with urgency given the surge in cases exponentially?

PEP: A Lifeline After Exposure

Administering the Mpox vaccine as PEP, ideally within four days of exposure but potentially up to 14 days, can significantly alter the course of the disease. Studies and real-world experience suggest that PEP can:

• Prevent infection: In many cases, timely vaccination after exposure can prevent the exposed individual from developing Mpox altogether.
• Reduce disease severity: Even if infection occurs, PEP can lead to milder symptoms, fewer complications, and a shorter duration of illness, ultimately saving lives and reducing the burden on the healthcare system.
• Limit onward transmission: By preventing or reducing the severity of the disease in exposed individuals, PEP plays a vital role in breaking the chain of infection within communities.

Sponsors of Mpox Vaccination in Africa and West Africa

Several international organizations and governments are playing a crucial role in supporting Mpox vaccination efforts across Africa, including West Africa and Sierra Leone, currently recording in hundred cases daily require and urgent stock pile. Below are some health partners providing vaccinations;

• Gavi, the Vaccine Alliance: Gavi has been instrumental in securing and distributing vaccine doses to African countries, including the recent shipment of 58,300 doses to Sierra Leone. They also often cover operational costs associated with vaccination campaigns.
• World Health Organization (WHO): The WHO provides technical guidance, supports the development of vaccination plans, and facilitates access to vaccines. They have also prequalified the MVA-BN vaccine, a key vaccine used against Mpox.
• UNICEF: UNICEF assists with the logistics of vaccine shipments, including procurement, customs clearance, storage, and transportation to ensure vaccines reach those in need.
• Bilateral Donations: Countries like the Republic of Ireland have also directly donated vaccine doses to affected nations like Sierra Leone.
• CEPI (Coalition for Epidemic Preparedness Innovations): CEPI is investing in research and development to advance Mpox vaccine availability and is partnering with manufacturers to support clinical trials in Africa, including studies focused on children.
• The European Union (EU) and the United States Government: These entities have also provided significant financial and in-kind support, including vaccine donations, to countries battling Mpox outbreaks in Africa.

Challenges to Available Vaccinations

Despite these efforts, several challenges hinder the widespread availability and uptake of Mpox vaccines in West Africa and across the continent:

• Limited Supply: Global production of Mpox vaccines remains concentrated in a few high-income countries, leading to supply constraints and delays in shipments to Africa.
• Logistical Hurdles: Maintaining the cold chain, reaching remote communities, and deploying trained healthcare workers for vaccine administration pose significant logistical challenges, particularly in resource-limited settings.
• Funding Constraints: Many African nations rely on external funding for vaccine procurement and operational costs, making them vulnerable to delays and shortages.
• Vaccine Hesitancy and Misinformation: Fear and misinformation surrounding the vaccine can lead to hesitancy within communities, hindering vaccination efforts.
• Regulatory Barriers: Some African countries face regulatory hurdles in approving and deploying the Mpox vaccine, even when supplies are available.
• Equitable Distribution: Ensuring that vaccines reach the most vulnerable populations and high-risk areas remains a challenge requiring effective targeting strategies.

Sierra Leone’s Ministry of Health Efforts

The Ministry of Health in Sierra Leone has been actively working to combat the ongoing Mpox outbreak taking measures such as:

• Public Health Emergency Declaration: The government declared Mpox a public health emergency in January 2025, signaling the seriousness of the situation and allowing for the mobilization of resources.
• Enhanced Surveillance: The National Public Health Agency (NPHA) has intensified case detection and contact tracing efforts to identify and monitor infections.
• Establishment of Treatment Centers: Dedicated Mpox treatment centers have been established, particularly in high-incidence areas like Freetown, to provide care for infected individuals.
• Risk Communication and Community Engagement: The Ministry is working to raise public awareness about Mpox symptoms, transmission, and preventive measures, as well as address misinformation.
• Vaccination Campaigns: With the arrival of over 61,000 vaccine doses, the Ministry has commenced targeted vaccination campaigns, prioritizing frontline healthcare workers, high-risk individuals, and contacts of confirmed cases, including children aged 12 and older.
• National Case Search Operations: The NPHA has implemented nationwide case search operations to better understand the extent of the outbreak and target interventions effectively.
• Collaboration with Partners: The Ministry is actively collaborating with international partners like WHO, UNICEF, Gavi, and Africa CDC for technical and logistical support, including vaccine acquisition and deployment.

In essence, post-exposure prophylaxis through vaccination offers a critical window of opportunity to save lives and reduce the spread of the escalating Mpox outbreak in Sierra Leone. While challenges in vaccine availability and distribution persist across Africa, the concerted efforts of international partners and the proactive response of the Sierra Leonean Ministry of Health, including targeted vaccination campaigns and robust public health measures, offer a glimmer of hope in containing this dangerous disease. Continued vigilance, community engagement, and sustained support will be crucial in winning this race against the Mpox virus.