Secondary Logo

Institutional members access full text with Ovid®

Dengue vaccines: implications for dengue control

Robinson, Matthew L.a; Durbin, Anna P.b

Current Opinion in Infectious Diseases: October 2017 - Volume 30 - Issue 5 - p 449–454
doi: 10.1097/QCO.0000000000000394
TROPICAL AND TRAVEL-ASSOCIATED DISEASES: Edited by Joseph M. Vinetz and Yukari C. Manabe
Buy

Purpose of review Dengue, the most common arbovirus, is an increasingly significant cause of morbidity worldwide. After decades of research, an approved tetravalent dengue vaccine is finally available. Models constructed using recently available vaccine efficacy data allow for a data-driven discussion of the potential impact of dengue vaccine deployment on global control.

Recent findings Phase 3 efficacy trials demonstrated that the approved dengue vaccine, chimeric yellow fever–dengue–tetravalent dengue vaccine, has an efficacy of 60% against dengue illness of any severity. However, among dengue unexposed recipients, vaccination offers limited efficacy and may increase dengue severity. The WHO consequently recommends dengue vaccination for populations in which 70% of intended recipients are dengue seropositive. Models predict that routine childhood dengue vaccine may reduce dengue burden, but over time, population-level impact may be limited. Additional vaccine candidates in late-stage development may not suffer from the same limitations as chimeric yellow fever–dengue–tetravalent dengue vaccine.

Summary The efficacy and safety profile of the recently approved dengue vaccine is favorable only in previously dengue exposed recipients, which limits its potential for global control. Future work must evaluate the approved vaccine's long-term durability, efficacy of other late phase vaccine candidates, and potential for vector control efforts to work synergistically with vaccine deployment.

aDivision of Infectious Disease, Johns Hopkins School of Medicine

bDepartment of International Health, Center for Immunization Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

Correspondence to Matthew L. Robinson, 600 North Wolfe Street, Phipps 540, Baltimore, MD 21287, USA. Tel: +1 443 287 2443; e-mail: mrobin85@jhmi.edu

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.