Dengue vaccine: Global development update

Abstract

The first licensed dengue vaccine, CYD-TDV (Dengvaxia®), has received regulatory approval in a number of countries. However, this vaccine has some limitations. Its efficacy against DENV2 was consistently lower than other serotypes. Protective efficacy also depended on prior dengue sero-status of the vaccinees. Lower efficacy was observed in children with < 9 years old and dengue-naïve individuals. More importantly, risk of hospitalization and severe dengue was increased in the youngest vaccine recipients (2-5 years) compared to controls. Thus, the quest of a better vaccine candidate continues. There are two live-attenuated vaccine candidates currently testing in phase III trial including DENVax, developed by US CDC and Inviragen (now licensed to Takeda) and TV003/TV005, constructed by US NIAID. In addition, there are several phase I-II as well as preclinical phase studies evaluating vaccines for safety and immunogenicity, this include other live-attenuated platform/strategy, purified-inactivated viruses formulated with adjuvants, DNA vaccine, subunit vaccine, viral vector and also heterologous prime/boost strategies. The major difficulties of dengue vaccine development are included the lack of the best animal model, various immune status of individual especially in endemic areas and clear cut off of protective immunity. Several research and development efforts are ongoing to find a better effective and accessible dengue vaccine for people needed.

Long-Term Protection Elicited by a DNA Vaccine Candidate Expressing the prM-E Antigen of Dengue Virus Serotype 3 in Mice

“…To resolve this significant, international public health problem, considerable effort has been directed toward the development of safe dengue vaccines. A number of candidates have been reported, including inactivated vaccines, live-attenuated vaccines, DNA vaccines, and subunit protein vaccines (Eckels and Putnak, 2003;Whitehead, 2016;Bustos-Arriaga et al, 2018;Manoff et al, 2019;Prompetchara et al, 2019;Wang et al, 2019). Of great concern, the first and only licensed dengue vaccine, Dengvaxia, had been approved for use in endemic areas owing to its higher efficacy among participants vaccinated at age ≥9 years (Ferguson et al, 2016;Henein et al, 2017); however, a post-hoc analysis of safety and efficacy reported a higher risk of severe dengue attack and hospitalization in vaccinated persons who had not been exposed to dengue (Sridhar et al, 2018).…”

Knowledge, awareness and preventive practices of dengue outbreak in Bangladesh: a countrywide study

“…The participation largely depends on peoples' knowledge, awareness and attitude towards this disease. But the effective dengue prevention and control is a burning question today in Bangladesh as there is an ongoing challenge to ensure proper treatment and prevention options despite having continued progress in dengue research [15,16]. In prior studies, it was shown that illiteracy, poverty and social incognizance are responsible factors for poor dengue management [17].…”

Dengue Serotypes in Bangladesh: Whole Genome Sequencing and Comparative Genomics Facilitates Pathogenesis and Epidemiology Studies and Informs Improved Disease Control

“…Despite continued progress in dengue research, it remains an ongoing challenge to identify definitive treatment and prevention options [20,21]. Therefore, it is of particular importance to reveal the genotypes of circulating DENV isolates distributed in different endemic countries, including Bangladesh, the focus of this article.…”