Current advice states that pregnant women should get monkeypox vaccines or treatment if the benefits outweigh any risks. However, there is limited evidence to support the provision of care for this high-risk patient group due to a lack of safety and efficacy data. We must learn from the COVID-19 epidemic and plan for the future. This includes a consistent, unified approach as well as the infrastructure and global registers for linked pregnancy and vaccine surveillance systems. These registries will allow us to quickly collect safety data and other information during the Emergency Use Authorizations (EUA) approval periods. These registries and infrastructures are currently only available to HICs. However, the data from affected HICs could be beneficial for pregnant women and infants from both low- and medium-income countries (LMICs) as well.
However, it is important to recognize that if adequate investment was made to create systems to prevent, treat, and collect robust data in LMICs, where monkeypox has endemic for many years, we would have greatly benefited the health of these populations and would have more evidence to aid prevention and treatment during this current outbreak. It is crucial that vaccines and treatments for monkeypox are made readily available to LMICs where there are many more cases.
The COVID-19 and current monkeypox pandemics should be used to guide the development and implementation of a consistent and uniform approach to rare diseases prevention and investigation. This applies not only to pregnant women, but also to other vulnerable and high risk groups such as children, immunocompromised people and LMICs.
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