Abstract
Recommendations have been issued for vaccinating with the Sanofi Pasteur tetravalent dengue vaccine (CYD-TDV, Dengvaxia®) individuals aged from 9 to 45/60 years old with a prior dengue virus (DENV) infection and living in endemic countries/areas. One question linked to these recommendations is to determine when it is possible to start vaccination after laboratory confirmed wild-type DENV infection, and this question can be relevant to any live vaccine to be used in endemic areas. To address it, we reviewed and discussed the immunological and practical considerations of live vaccination in this context. Firstly, the nature and kinetics of immune responses triggered by primary or secondary DENV infection may positively or negatively impact subsequent live vaccine take and associated clinical benefit, depending on when vaccination is performed after infection. Secondly, regarding practical aspects, the “easiest” situation would correspond to a confirmed acute dengue fever, only requiring knowing when the patient should come back for vaccination. However, in most cases, it will not be possible to firmly establish the actual date of infection and vaccination may have to take place during well-defined periods, regardless of when prior infection occurred. Evidence that informs health authorities and medical practitioners in formulating vaccine policies and implementing vaccine programs is thus needed. The present work reviewed the different elements of the guidance and proposes some key conclusions and recommendations.
Highlights
The Sanofi Pasteur chimeric yellow fever-dengue tetravalent dengue vaccine (CYD-TDV, Dengvaxia® ) is used for the prevention of acute dengue caused by any of the four serotypes of dengue virus (DENV)
The “easiest” one would correspond to a confirmed acute dengue fever: when can vaccination be performed after such an acute infection? When should the patient come back? it is likely that the actual date of infection cannot firmly be established in most instances
The present document presents a short summary of wild type dengue virus-induced responses and kinetics, and how they can interfere with live vaccine-induced immunity when vaccination is performed at different times after infection
Summary
The Sanofi Pasteur chimeric yellow fever-dengue tetravalent dengue vaccine (CYD-TDV, Dengvaxia® ) is used for the prevention of acute dengue caused by any of the four serotypes of dengue virus (DENV) This vaccine is licensed for use in individuals aged from 9 to 45 or 60 years old and living in endemic countries/areas with confirmed prior DENV infection. This population with prior DENV infection is at risk of secondary DENV infection, which is associated with increased risk of severe and hospitalized dengue.
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