Dengue Fever Vaccine Update: Current Vaccines & Future Prospects

Estimated reading time: 8 minutes

The fight against dengue fever has seen significant developments in vaccine technology, yet challenges remain. Let’s delve into the specifics of currently available and recently approved vaccines:

Dengvaxia, developed by Sanofi Pasteur, was the first licensed dengue vaccine. However, its journey has been marked by significant setbacks. While initially showing promise in reducing severe dengue and hospitalization rates in individuals with prior dengue infection, the World Health Organization (WHO) Global Advisory Committee on Vaccine Safety (GACVS) issued a crucial recommendation. They found that dengue-naïve individuals (those without prior infection) faced a heightened risk of severe dengue following vaccination. This finding led to restricted usage and ultimately, Sanofi Pasteur discontinued production due to decreased global demand. The complexities surrounding Dengvaxia underscore the challenges in developing effective dengue vaccines and the importance of rigorous post-market surveillance. The legal ramifications in the Philippines further highlight the need for transparency and accountability in vaccine development and deployment. In the United States, Dengvaxia is only available to children in Puerto Rico with confirmed previous dengue infection.

Takeda’s Qdenga represents a significant leap forward. This live-attenuated tetravalent vaccine targets all four dengue serotypes (DENV-1, DENV-2, DENV-3, and DENV-4). Currently, it’s the only dengue vaccine recommended by the WHO for use in children aged 6–16 years in high-transmission areas. Results from the pivotal Phase 3 TIDES trial demonstrated impressive efficacy: 80.2% overall vaccine efficacy against virologically-confirmed dengue (VCD) at 12 months, and 90.4% efficacy against hospitalization due to VCD. Long-term follow-up data further reinforced its effectiveness.

However, Qdenga’s efficacy isn’t uniform across all serotypes and prior infection statuses. While highly effective against all four serotypes in seropositive individuals (those with prior infection), its efficacy against DENV-3 in seronegative individuals was not observed. This highlights the importance of understanding an individual’s dengue history before vaccination.

Qdenga has received approvals in numerous countries, including the United Kingdom and 18 European nations, and was added to the WHO’s List of Prequalified Vaccines in May 2024. Brazil’s proactive integration of Qdenga into its public health system, initiating a mass vaccination campaign, marks a significant step towards dengue control. Post-market surveillance in Brazil is ongoing, monitoring reported hypersensitivity reactions, including anaphylaxis. In the United States, Takeda’s Biologics License Application (BLA) was voluntarily withdrawn, pending further discussion with the FDA. The UK’s JCVI recommends Qdenga for individuals aged 4 years and older with past dengue infection traveling to or working in high-risk areas, but not for dengue-naïve individuals due to insufficient data and theoretical risks.

The WHO stresses that vaccination alone is insufficient to control dengue fever. A comprehensive strategy must incorporate:

The landscape of dengue fever vaccination is dynamic and constantly evolving. While Qdenga represents a significant advancement, the ongoing research into new vaccine candidates, coupled with a multi-pronged approach to disease control, offers hope for a future with significantly reduced dengue burden. The challenges highlighted by Dengvaxia’s experience underscore the need for rigorous clinical trials, transparent communication, and a holistic approach to managing this persistent global health threat.

To learn more about how our expertise in infectious disease management can support your organization’s efforts in dengue prevention and control, contact us today for a consultation. We offer tailored strategies for businesses, healthcare providers, and public health institutions operating in dengue-endemic regions.