The Strategic Advisory Group of Experts (SAGE) of the World Health Organization (WHO) recently issued new recommendations regarding the available Dengue vaccine. This post summarizes available information about the dengue vaccine.
Key Messages:
Dengue Vaccine
Type: Tetravalent (Recombinant) Live Attenuated Vaccine
Name: CYD-TDV
Commercial name: Dengvaxia®
Administration
Age: 9-45 years or 9-60 years
Route: Injection (? Intramuscular- not specified, but most likely)
Schedule: 0/6/12 months
Vaccine Efficacy (estimated from two trials):
Vaccine efficacy over 25 months from the first vaccine dose among 9-16 year-olds, using data pooled from both trials, was 65.6% (95%CI 60.7-69.9).
The sub-group benefit profile is complex: vaccine efficacy varied by infecting virus (higher protection against DENV 3 and 4 than DENV 1 and 2), age (higher protection in older children), disease severity (higher protection against hospitalized and severe dengue), and serostatus at the time of vaccination (higher protection in participants who had already been exposed to dengue virus).
Precautions: Data regarding interactions with other vaccines not available, so do not co-administer other live attenuated vaccines. The risk of interaction with Non-live vaccines is considered small, so permissible.
Introduction (National/ subnational level): Only recommended for areas with dengue seroprevalence 70% or higher. NOT recommended when seroprevalence is 50% or lower.
Estimated benefit: The introduction of routine CYD-TDV vaccination in early adolescence could reduce dengue hospitalizations by 10-30% over a period of 30 years, representing a substantial public health benefit.
Useful Links:
Link to the SAGE meeting web summary (English) [PDF]:
http://who.int/immunization/sage/meetings/2016/april/SAGE_April_2016_Meeting_Web_summary.pdf?ua=1
Link to UK NHS page providing dengue vaccine details:
http://www.ukmi.nhs.uk/applications/ndo/record_view_open.asp?newDrugID=5814
Link to another site providing details of the dengue vaccine:
communitymedicine4all 