New recommendations for dengue vaccine
Dengue is a mosquito-borne flavivirus disease that has spread to most tropical and many subtropical areas. The disease is caused by four closely related viruses, the Dengue viruses 1-4. There are no specific dengue therapeutics and prevention is currently limited to vector control measures. A dengue vaccine would therefore represent a major advance in the control of the disease.
The first dengue vaccine, Dengvaxia (CYD-TDV) by Sanofi Pasteur, was first registered in Mexico in December, 2015. CYD-TDV is a live recombinant tetravalent dengue vaccine that has been evaluated as a three-dose series on a 0/6/12 month schedule in Phase III clinical studies. It has been registered for use in individuals 9-45 years of age living in endemic areas.
The WHO Strategic Advisory Group of Experts (SAGE) on Immunization reviewed CYD-TDV in April 2016 and recommended countries consider introduction of the vaccine only in geographic settings (national or subnational) with high endemicity. A WHO vaccine position paper will be published outlining WHO recommendations in July 2016.
There are approximately five additional vaccine candidates under evaluation in clinical trials, including other live-attenuated vaccines, as well as subunit, DNA and purified inactivated vaccine candidates. Additional technological approaches, such as virus-vectored and VLP-based vaccines, are under evaluation in preclinical studies.
The growing global epidemic of dengue is of mounting concern, and a safe and effective vaccine is urgently needed. WHO expects vaccines to be an integrated part of the Global dengue prevention and control strategy (2012-2020).