Dengvaxia: the world’s first vaccine for prevention of secondary dengue

Abstract

The objective of this manuscript was to review and evaluate the efficacy and safety data of Dengvaxia for the treatment of severe secondary dengue infection. Dengvaxia is the brand name for chimeric yellow fever-dengue-tetravalent dengue vaccine (CYD-TDV). A literature search through PubMed was conducted using the keywords ‘dengue vaccine’, ‘Dengvaxia’, ‘efficacy’ or ‘safety’. Trials were selected if they appropriately assessed vaccine efficacy or were related to the vaccine approval process for CYD-TDV. Findings from this review underline the evolution of vaccine efficacy against seroprevalence, serotypes, and various ages. There are currently no preventive measures or antiviral treatments for dengue; CYD-TDV is the first vaccine to receive US Food and Drug Administration approval. Protective responses seen with the complete administration of CYD-TDV can become a standardized tool as part of a world vaccination program.

Dengue Fever in Italy: The “Eternal Return” of an Emerging Arboviral Disease

“…In other words, dengue should still be acknowledged as an "alien" and sporadic pathogen on the edge of endemization, and on the very same path previously followed by other arboviruses such as WNV. In this regard, it should be stressed that while no vaccines against WNV are to date available, a vaccine for DENV (Dengvaxia ® ) has been approved by the U.S. Food and Drug Administration (FDA) in the United States for use in children aged 9 to 16 years with laboratory-confirmed previous dengue virus infection and residence in an area where dengue is endemic (where dengue occurs frequently or continuously) [55][56][57]. Moreover, in June 2021, the Advisory Committee on Immunization Practices (ACIP) recommended use of Dengvaxia ® to prevent dengue in children aged between 9 and 16 years [58].…”

“…While in high-risk areas the massive vaccination campaigns may be cost-effective [59], available data hardly support the extensive vaccination against DENV in travelers [60]. In settings characterized by very limited autochthonous circulation, if any, and relatively few reported cases (in the peak years of 2019, 1.514 per 100,000 travelers, 95% CI 1.305-1.746), despite its reported efficacy, with a cost of around US Dollars 60-69 for completing the three-dose schedule, total costs would overwhelm potential sparing [56,57,61,62]. In fact, according to ISTAT estimates on travel between 2010-2019, an average of around 538,383 travelers/year to high-risk areas in Asia and 279,029 travelers/year to South America may be calculated.…”

“…In a worst-case scenario where all travelers are required to complete their vaccination schedule, expenses faced by Italian National Health Service would range between EUR 49,044,720 and EUR 56,401,428 in order to avoid no more than 185 cases (i.e., the peak of crude incidence from 2019). Even assuming that all of them may have required advanced healthcare, correspondent efficacy of Dengvaxia ® in avoiding recipient hospitalizations ranges between 80.8% in adults and 56.1% in children [55][56][57]61]: as 93.7% of reported cases occurred in adults, if all individuals traveling to high-risk areas would receive a full vaccination schedule, assuming a scenario similar to 2019, vaccination would have spared around 146 cases, with a total cost of EUR 335,922 to EUR 386,311 for averted cases.…”

Mucosal Vaccination: A Promising Alternative Against Flaviviruses

“…One of the best vaccines ever developed so far is against YFV, the YF17D attenuated vaccine, which is effective and safe; due to these characteristics, it has been used as a backbone for other vaccines ( Guirakhoo et al., 1999 ). Conversely, Dengvaxia, the licensed vaccine against DENV has rendered different protective responses (around 30-70%) depending on previous immune status, age, and genotypic variation within each serotype that individuals are exposed to ( Tully and Griffiths, 2021 ). Therefore, further improvements to DENV vaccines or against WNV and ZIKV, which do not have licensed vaccines, are mandatories.…”

Updates on Dengue Vaccine and Antiviral: Where Are We Heading?

“…Receiving FDA approval in 2015, this vaccine is now accessible in more than 20 countries. Its usage has been allowed with strict restrictions on the recipients' age and serostatus [32]. It offers high effectiveness in preventing dengue disease caused by DENV serotypes 1-4 and is safe in people who have had a past dengue infection, i.e., those who are seropositive.…”