Dengue vaccine

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Dengue vaccine
Vaccine description
Target disease Dengue fever
Type ?
  • none

Dengue vaccine is a vaccine to prevent dengue fever in humans. The World Health Organization only recommends the vaccine as a possible option in areas of the world where the disease is common.[1]

The development of vaccine for dengue fever began as early as 1929, but has been hindered first by incomplete knowledge of the disease pathogenesis, and later by the need to simultaneously create a stable immunity against all four dengue serotypes. Several vaccine candidates are in development including live attenuated, inactivated, DNA and subunit vaccines. Live attenuated vaccine candidates are the furthest along in development.[2]

In 2016 a partially effective vaccine for dengue fever (Dengvaxia) became commercially available in the Philippines and Indonesia.[3][4] It has also been approved for use by Mexico, Brazil, El Salvador, Costa Rica, and Paraguay.[4] In Indonesia it costs about US$207 for the recommended three doses.[4]


CYD-TDV, sold under the brand name Dengvaxia, is a live attenuated tetravalent chimeric vaccine made using recombinant DNA technology by replacing the PrM (pre-membrane) and E (envelope) structural genes of the yellow fever attenuated 17D strain vaccine with those from four of the five dengue serotypes.[5][6] Ongoing phase III trials in Latin America and Asia involve over 31,000 children between the ages of 2 and 14 years. In the first reports from the trials, vaccine efficacy was 56.5% in the Asian study and 64.7% in the Latin American study in patients who received at least one injection of the vaccine.[7][8] Efficacy varied by serotype. In both trials vaccine reduced by about 80% the number of severe dengue cases.[9] An analysis of both the Latin American and Asian studies at the 3rd year of follow-up showed that the efficacy of the vaccine was 65.6% in preventing hospitalization in children older than 9 years of age, but considerably greater (81.9%) for children who were seropositive (indicating previous dengue infection) at baseline.[10] The vaccination series consists of three injections at 0, 6 and 12 months.[6] The vaccine was approved in Mexico, Philippines, and Brazil in December 2015, expected to be the first among the 20 countries in the coming weeks. Tradenamed Dengvaxia, it is approved for use for those aged nine and older and can prevent all four serotypes.[11]


DENVax is a recombinant chimeric vaccine with DENV1, DENV3, and DENV4 components on a dengue virus type 2 (DENV2) backbone developed at Mahidol University in Bangkok.[12] Phase I and II trials are ongoing in the United States, Colombia, Puerto Rico, Singapore and Thailand.[13]


TetraVax-DV is a tetravalent admixture of monovalent vaccines that were tested separately for safety and immunogenicity. The vaccine passed phase I trials and is being tested in phase II studies in Thailand and Brazil.[14] In Brazil, the studies are being done in collaboration with the Instituto Butantan.


TDEN PIV is inactivated tetravalent vaccine undergoing phase I trials as part of a collaboration between GSK and the Walter Reed Army Institute of Research. A synergistic formulation with another live attenuated candidate vaccine (prime-boost strategy) is also being evaluated in a phase II study. In prime-boosting, one type of vaccine is followed by a boost with another type in an attempt to improve immunogenicity.[15]


Merck is studying recombinant subunit vaccines expressed in Drosophila cells. Studies are in phase I stage as of 2015.[15]

DNA vaccines[edit]

The Naval Medical Research Center attempted to develop a monovalent DNA plasmid vaccine, but early results showed it to be only moderately immunogenic.[13]

Manufacturer in India and Vietnam[edit]

Panacea Biotec and Biological E. Limited have vaccine candidates in the earliest stages of development. A company in Vietnam (VABIOTECH) is conducting safety tests and developing a clinical trial plan.[16] All three companies are involved in studies of a TetraVax-DV vaccine in conjunction with the National Institutes of Health.[17]


  1. ^ "Dengue vaccine: WHO position paper – July 2016." (PDF). Releve epidemiologique hebdomadaire. 91 (30): 349–64. 29 July 2016. PMID 27476189. 
  2. ^ McArthur, MA; Sztein, MB; Edelman, R (August 2013). "Dengue vaccines: recent developments, ongoing challenges and current candidates.". Expert Review of Vaccines. 12 (8): 933–53. PMID 23984962. doi:10.1586/14760584.2013.815412. 
  3. ^ East, Susie (6 April 2016). "World's first dengue fever vaccine launched in the Philippines". CNN. Retrieved 17 October 2016. 
  4. ^ a b c "Dengue Fever Vaccine Available in Indonesia". October 17, 2016. 
  5. ^ Thisyakorn, U. (2014). "Latest developments and future directions in dengue vaccines". Therapeutic Advances in Vaccines. 2 (1): 3–9. doi:10.1177/2051013613507862. 
  6. ^ a b Yauch, Lauren E. (2014). "Dengue Virus Vaccine Development". Advances in Virus Research: 315–372. doi:10.1016/B978-0-12-800098-4.00007-6. 
  7. ^ Capeding, MR; Tran, NH; Hadinegoro, SR; Ismail, HI; Chotpitayasunondh, T; Chua, MN; Luong, CQ; Rusmil, K; Wirawan, DN; Nallusamy, R; Pitisuttithum, P; Thisyakorn, U; Yoon, IK; van der Vliet, D; Langevin, E; Laot, T; Hutagalung, Y; Frago, C; Boaz, M; Wartel, TA; Tornieporth, NG; Saville, M; Bouckenooghe, A; CYD14 Study, Group (11 October 2014). "Clinical efficacy and safety of a novel tetravalent dengue vaccine in healthy children in Asia: a phase 3, randomised, observer-masked, placebo-controlled trial.". Lancet (London, England). 384 (9951): 1358–65. PMID 25018116. doi:10.1016/s0140-6736(14)61060-6. 
  8. ^ Villar, L; Dayan, GH; Arredondo-García, JL; Rivera, DM; Cunha, R; Deseda, C; Reynales, H; Costa, MS; Morales-Ramírez, JO; Carrasquilla, G; Rey, LC; Dietze, R; Luz, K; Rivas, E; Miranda Montoya, MC; Cortés Supelano, M; Zambrano, B; Langevin, E; Boaz, M; Tornieporth, N; Saville, M; Noriega, F; CYD15 Study, Group (8 January 2015). "Efficacy of a tetravalent dengue vaccine in children in Latin America.". The New England Journal of Medicine. 372 (2): 113–23. PMID 25365753. doi:10.1056/nejmoa1411037. 
  9. ^ "The Lancet: World's Most Advanced Dengue Vaccine Candidate Shows Promise in Phase 3 Trial". Science Newsline medicne. 10 July 2014. Retrieved 13 July 2014. 
  10. ^ Hadinegoro, SR; Arredondo-García, JL; Capeding, MR; Deseda, C; Chotpitayasunondh, T; Dietze, R; Ismail, HI; Reynales, H; Limkittikul, K; Rivera-Medina, DM; Tran, HN; Bouckenooghe, A; Chansinghakul, D; Cortés, M; Fanouillere, K; Forrat, R; Frago, C; Gailhardou, S; Jackson, N; Noriega, F; Plennevaux, E; Wartel, TA; Zambrano, B; Saville, M; CYD-TDV Dengue Vaccine Working, Group (27 July 2015). "Efficacy and Long-Term Safety of a Dengue Vaccine in Regions of Endemic Disease.". The New England Journal of Medicine. 373: 1195–206. PMID 26214039. doi:10.1056/NEJMoa1506223. 
  11. ^ Palmer, Eric (9 December 2015). "Sanofi gets first approval for long-anticipated vaccine against dengue fever". Retrieved 10 December 2015. 
  12. ^ Osorio, JE; Huang, CY; Kinney, RM; Stinchcomb, DT (23 September 2011). "Development of DENVax: a chimeric dengue-2 PDK-53-based tetravalent vaccine for protection against dengue fever.". Vaccine. 29 (42): 7251–60. PMC 4592106Freely accessible. PMID 21777638. doi:10.1016/j.vaccine.2011.07.020. 
  13. ^ a b Schwartz, LM; Halloran, ME; Durbin, AP; Longini IM, Jr (26 June 2015). "The dengue vaccine pipeline: Implications for the future of dengue control.". Vaccine. 33 (29): 3293–3298. PMC 4470297Freely accessible. PMID 25989449. doi:10.1016/j.vaccine.2015.05.010. 
  14. ^ "NIH-Developed Candidate Dengue Vaccine Shows Promise in Early-Stage Trial". National Institute of Allergy and Infectious Diseases. Retrieved 30 July 2015. 
  15. ^ a b McArthur, MA; Sztein, MB; Edelman, R (August 2013). "Dengue vaccines: recent developments, ongoing challenges and current candidates.". Expert review of vaccines. 12 (8): 933–53. PMC 3773977Freely accessible. PMID 23984962. doi:10.1586/14760584.2013.815412. 
  16. ^ "Vaccine Development. Dengue Vaccine Initiative". Retrieved 31 July 2015. 
  17. ^ Roehrig, John T. "Current Status of Dengue Vaccine Development" (PDF). Retrieved 31 July 2015. 

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