A new commentary draws attention to how financial and legal barriers undermine efforts to vaccinate children during mpox outbreaks. Although children account for a large share of suspected cases and deaths, they were excluded from vaccine roll-out in the Democratic Republic of Congo during the first 100 days of the outbreak. The authors from Médecins Sans Frontières argue that delayed inclusion of children and pregnant women in trials is only part of the problem. Just as critical are the disincentives facing manufacturers and governments, including the absence of indemnification and liability protections.
These constraints reveal how outbreak responses can be affected by regulatory hurdles. Without clear mechanisms to share liability and cover costs for off-label or emergency vaccination, manufacturers may be reluctant to supply doses and governments may hesitate to deploy them. The authors call for global coordination, especially through WHO and international financing partners, to ensure that regulatory considerations models are built into emergency vaccine responses. Addressing such obstacles would help guarantee that the youngest and most vulnerable populations are not left behind in future outbreaks.
Thumbnail image credit: WHO
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