India may selectively vaccinate close contacts of monkeypox patients and healthcare workers instead of going for mass vaccinations, an official aware of the plans said. The so-called ‘ring vaccination’ strategy is already adopted by the US and some European countries.India has reported nine confirmed cases of monkeypox so far, and the Union government believes that at present, vaccinating the general population is not required. The Indian Council Medical Research’s (ICMR) National Institute of Virology in Pune isolated the monkeypox strain and invited pharma companies to explore options for development of vaccines and diagnostic kits.“Ring vaccination means that if any individual is infected, his/her immediate contacts are vaccinated to stop further spread of the disease. So, as of now, vaccination is not recommended in a generalized way in any of the countries. But we may opt for ring vaccination strategy as far as monkeypox is concerned; however, we have not taken any call on it,” the official said on the condition of anonymity.The ICMR wants private players to decide if they want to manufacture the vaccine or not, given that vaccine is not for mass use, added the official. “However, to be on safer side, the Union health and welfare ministry may buy some vaccines which are already available, but will not issue any guidelines for mass vaccination,” said the official.Queries emailed to a health ministry spokesperson remained answered.The official said, “Monkeypox requires symptomatic treatment and the World Health Organization has not authorized any drug for the treatment of monkeypox. It’s a self-limiting disease that does not require any specific treatment.”However, the US FDA has okayed only one drug Tecovirimat for the treatment, but it is not approved by Indian regulatory authorities.Experts said that at present there is no vaccine that is specifically made for monkeypox, and those available worldwide are made of a related virus called vaccinia.“Presently, two vaccines--- ACAM2000 and Jynneos are available worldwide, but these vaccines were invented to counter the smallpox threat. They don’t contain the Monkeypox virus. But it has been noted that these two vaccines offer some cross-protection against monkeypox. That’s why people believe that it can be used for ring vaccination. However, they have not yet been used for clinical trials in actual monkeypox patients. They also have a significant side effect profile including 1-2% non-fatal cardiac adverse effect risk. This has to be balanced against the potential benefit,” said Rajeev Jayadevan, Co-Chairman National IMA COVID task force.“Ring vaccination is a strategy being used worldwide against Monkeypox now. India is in the early stage of the monkeypox outbreak. We should carefully select who requires the vaccine, and also simultaneously generate the outcome data, which will help guide future decisions. Vaccination should be considered for high-risk populations which include partners of infected persons, close contacts and healthcare workers who regularly treat monkeypox patients. The public needs to understand that monkeypox vaccine is not for everybody, and only for high-risk individuals,” Jayadevan added.