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The potential impact of monkeypox infection and vaccination on blood donor deferrals and the blood supply - BJH

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  • The potential impact of monkeypox infection and vaccination on blood donor deferrals and the blood supply - BJH

    British Journal of Haematology

    First published: 27 July 2022

    Jeremy W. Jacobs, Laura Filkins, Garrett S. Booth, Brian D. Adkins

    ... Currently, no in vitro screening assay for monkeypox virus in blood donors exists, and regarding monkeypox, the Association for the Advancement of Blood and Biotherapies (AABB) has stated that “evidence does not support the implementation of a donor question or provision of written donor education materials.”2 The AABB did offer prescriptive recommendations for centres choosing to defer, with donation allowed after resolution of symptoms with complete separation of scabs or a minimum of 21 days deferral after asymptomatic exposure.2 While many cases of monkeypox infection have been identified in individuals who would likely be deferred from blood donation based on social practices [e.g. men who have sex with men (MSM)], the US Centers for Disease Control (CDC) states that any individual having close contact with a person infected with monkeypox is at risk of acquiring the disease.8Furthermore, multiple studies have demonstrated that members of the MSM community donate blood despite the self-exclusion questions.9 Therefore, blood donation deferral policies based on self-exclusion questions for social practices cannot be expected to completely eliminate the threat of monkeypox infection to the blood supply.

    While viraemia does not necessarily equate to transfusion transmissibility, given that current knowledge of viraemia, infectivity, and transmissibility via blood transfusion is limited, there is significant need to investigate the potential for transfusion transmission via focused studies on detection of monkeypox DNA and infectivity in relevant patient and blood donor populations (e.g., donors with multiple sexual partners of recent syphilis seroreactivity). Furthermore, evaluation of the potential for transfusion transmission during presymptomatic or asymptomatic infection, and the development of appropriate animal models to answer these questions are needed, as mounting evidence suggests that asymptomatic monkeypox infection may be theoretically possible.10

    ... As countries begin to vaccinate high-risk individuals and contacts of possible or confirmed cases, the use of these vaccines is expected to increase, as evidenced by the recent announcement regarding vaccinations in New York City, US and Ottawa, Canada.14, 15

    While studies are currently underway to evaluate the efficacy and side effects of the JYNNEOS, and potentially other, monkeypox vaccines, one unknown consequence of this abrupt implementation is the potential impact on the international blood supply.