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dengue virus vaccine (Dengvaxia)

Indications: - prevention of dengue fever [1] - live attenuated vaccine for prevention of all 4 dengue serotypes in young persons 9-16 years with lab-confirmed prior dengue infection & who live in endemic areas (American Samoa, Guam, Puerto Rico, Virgin Islands) Contraindications: - should not be used in people without previous dengue infection Dosage: - 3 injections at 0, 6, & 12 months [5] Adverse effects: - headache, myalgia, arthralgia fatigue, injection site pain, low-grade fever Notes: - 56-76% effective - efficacy against symptomatic virologically confirmed dengue 61% - efficacy against severe dengue > 90% - efficacy against hospitalization 80% - not effective against serotype 2 - efficacy lower in younger than in older children [3] - tetravalent dengue vaccine (CYD-TDV) protects against severe virologically-confirmed dengue for 5 years in persons who had exposure to dengue before vaccination [4], - evidence of a higher risk for severe dengue in vaccinated persons who had not been exposed to dengue [4] - appears to act like a first dengue infection, such that a subsequent infection can result in severe dengue, thus not for dengue niave persons

Related

dengue virus dengue; bone break fever; dandy fever; Duengero fever; 7 day fever

General

live virus vaccine

References

  1. Capeding MR et al Clinical efficacy and safety of a novel tetravalent dengue vaccine in healthy children in Asia: a phase 3, randomised, observer-masked, placebo-controlled trial. The Lancet, Early Online Publication, 11 July 2014 PMID: 25018116 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2961060-6/abstract - Wilder-Smith A Dengue vaccines: dawning at last? The Lancet, Early Online Publication, 11 July 2014 PMID: 25018119 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2961142-9/fulltext
  2. Villar L et al Efficacy of a Tetravalent Dengue Vaccine in Children in Latin America. N Engl J Med. November 3, 2014 PMID: 25365753 http://www.nejm.org/doi/full/10.1056/NEJMoa1411037
  3. Hadinegoro SR et al. Efficacy and long-term safety of a dengue vaccine in regions of endemic disease. N Engl J Med 2015 Jul 27 PMID: 26214039 http://www.nejm.org/doi/full/10.1056/NEJMoa1506223 - Simmons CP. A candidate dengue vaccine walks a tightrope. N Engl J Med 2015 Jul 27 PMID: 26214040 http://www.nejm.org/doi/full/10.1056/NEJMe1509442
  4. Sridhar S, Luedtke A, Langevin E. Effect of Dengue Serostatus on Dengue Vaccine Safety and Efficacy. N Engl J Med. June 13, 2018 PMID: 29897841 https://www.nejm.org/doi/full/10.1056/NEJMoa1800820
  5. FDA news release. May 1, 2019 First FDA-approved vaccine for the prevention of dengue disease in endemic region. https://www.fda.gov/news-events/press-announcements/first-fda-approved-vaccine-prevention-dengue-disease-endemic-regions