Hundreds of Europeans have pushed borders for the monkeypox vaccine, sparking calls to address the glaring disparity in access to doses between nations.
The current outbreak began in Europe in May as the virus spread rapidly outside of areas in Africa where it has long been endemic.
The virus, which is rarely fatal but can cause extremely painful lesions, has overwhelmingly affected men who have sex with men, some of whom have tried to get vaccinated quickly.
However, some countries have had much larger and faster rollouts of the only approved monkeypox vaccine, a smallpox vaccine manufactured by Danish company Bavarian Nordic and marketed in Europe as Imvanex.
Belgium, for example, only has 3,000 doses, which are only available to LGBT sex workers, men who have sex with men with STIs or HIV, and some rare contact cases.
But neighboring France has far more cans. While the exact number is unknown, more than 53,000 doses have already been administered in the country.
During the European summer, many Belgians drove across the border to get a push.
Pharmacist Virginie Ceyssac said that 30 to 40 percent of those who were vaccinated at her Aprium pharmacy in the northern French city of Lille were Belgian.
– ‘Very warm’ welcome –
Samy Soussi of the Brussels-based HIV association ExAequo said that “thanks to word of mouth we knew that it was possible for Belgians to get vaccinated in France”.
ExAequo even contacted the Lille Vaccination Center to organize carpooling for Belgians attending a vaccination induction day on August 6th.
“444 Belgians were vaccinated this morning,” said Soussi, adding that they received a “very warm” welcome.
Around 90 percent of those vaccinated that day came from Belgium, the city hall of Lille told AFP.
The Hauts-de-France region’s health authority said its vaccination centers are asked to “react positively to requests from Belgian border residents, provided this does not affect access to vaccinations for the French”.
In France’s capital, vaccinations were also offered to people from outside the country.
“Foreign tourists have used their trip to get vaccinated,” said Checkpoint Paris, a sexual health center dedicated to LGBT people.
On the southern borders of France, however, Italians and Spaniards are very much in the minority when it comes to vaccinations, according to local HIV organizations.
Switzerland, meanwhile, has no vaccine doses of its own, although the government bowed to mounting criticism by announcing on Wednesday that it would buy 100,000 doses.
Lacking local doses, “some people have gone to France to be vaccinated with no problems, but others have been turned down,” said Alexandra Calmy, head of the HIV unit at Geneva University Hospitals.
Thomas, a 32-year-old from the Swiss town of Montreux, told AFP he spent a fortnight trying to get a vaccination appointment in France.
Eventually he managed to get an appointment in the eastern French town of Besançon.
“I’ve taken a day off, I’m going to rent a car and drive,” he said.
– “Expensive and unfair” –
A vaccination center in the French alpine town of Chambery in the Savoie department refused him an appointment.
“We only accept people who live in Savoy,” local doctor Silvere Biavat told AFP.
The center was “overwhelmed with calls from Swiss people” and had to turn them away due to a lack of resources, he added.
The DGS directorate of France’s health ministry said it was up to vaccinators whether to dose foreigners.
After being denied an appointment in France, Sergio, a 41-year-old who lives in Geneva, looked further away. First he tried his native Portugal, then the United States before finally getting a date in London.
“I paid almost 600 euros for a last-minute flight from Geneva to London,” he said.
“It’s expensive and it’s unfair because not everyone can do it … but everyone is afraid” of monkeypox, he said.
Inequality in access has prompted organizations and healthcare professionals across Europe to call for new diplomatic deals for dose distribution with countries in need.
“It is not logical that countries like France, Germany and the Netherlands have a large number of vaccines,” while countries like Spain – one of the hardest-hit countries in the world – only have 17,000 doses, said Toni Poveda, director of the Spanish HIV organization CESIDA.
Marc Dixneuf, head of the French group AIDES, said that “epidemics don’t pay much attention to borders”.
“What we want is a concerted response at European level, within the World Health Organization and not just the European Union – because we have to involve Switzerland,” he said.
French health officials said they are in contact with Belgium and Switzerland to discuss cross-border monkeypox vaccination, including funding.
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