Deliberations of the Strategic Advisory Group of Experts on Immunization on the use of CYD-TDV dengue vaccine

Deliberations of the Strategic Advisory Group of Experts on Immunization on the use of CYD-TDV dengue vaccine

The Strategic Advisory Group of Experts (SAGE) on Immunization advises WHO on global policies for vaccines. In April, 2016, SAGE issued recommendations on the use of the first licenced dengue vaccine, CYD-TDV. In November, 2017, a retrospective analysis of clinical trial data, stratifying participan...

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Bibliographic Details
Published in:The Lancet infectious diseases Vol. 19; no. 1; pp. e31 - e38
Main Authors: Wilder-Smith, Annelies, Hombach, Joachim, Ferguson, Neil, Selgelid, Michael, O'Brien, Kate, Vannice, Kirsten, Barrett, Alan, Ferdinand, Elizabeth, Flasche, Stefan, Guzman, Maria, Novaes, Hillegonde Maria, Ng, Lee-Ching, Smith, Peter G, Tharmaphornpilas, Piyanit, Yoon, In-Kyu, Cravioto, Alejandro, Farrar, Jeremy, Nolan, Terry M
Format: Journal Article
Language:English
Published: United States Elsevier Ltd 01-01-2019
Elsevier Limited
Subjects:
Adolescent
Age groups
Child
Child, Preschool
Cost analysis
Dengue fever
Dengue hemorrhagic fever
Dengue Vaccines - adverse effects
Dengue Vaccines - immunology
Dengue Virus - immunology
Diagnostic systems
Disease
Female
Humans
Immunization
Immunization, Secondary
Infections
Infectious diseases
Licenses
Male
Mass Screening
Population
Public health
Schedules
Screening
Seroepidemiologic Studies
Serology
Severe Dengue - prevention & control
Severe Dengue - virology
Treatment Outcome
Vaccination
Vaccines
Vaccines, Attenuated - immunology
Vector-borne diseases
Working groups
World Health Organization
Brazil
Thailand
Australia
Asia
Philippines
Latin America
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Summary:The Strategic Advisory Group of Experts (SAGE) on Immunization advises WHO on global policies for vaccines. In April, 2016, SAGE issued recommendations on the use of the first licenced dengue vaccine, CYD-TDV. In November, 2017, a retrospective analysis of clinical trial data, stratifying participants according to their dengue serostatus before the first vaccine dose, showed that although in high seroprevalence settings the vaccine provides overall population benefit, there was an excess risk of severe dengue in seronegative vaccinees. SAGE's working group on dengue vaccines met to discuss the new data and mainly considered two vaccination strategies: vaccination of populations with dengue seroprevalence rates above 80% or screening of individuals before vaccination, and vaccinating only seropositive individuals. We report on the deliberations that informed the recommendation of the pre-vaccination screening strategy, in April, 2018. Important research and implementation questions remain for CYD-TDV, including the development of a highly sensitive and specific rapid diagnostic test to determine serostatus, simplified immunisation schedules, and assessment of the need for booster doses.
ISSN:1473-3099
1474-4457
DOI:10.1016/S1473-3099(18)30494-8