First Experience of Concomitant Vaccination Against Dengue and MMR in Toddlers

• Published in: The Pediatric infectious disease journal Vol. 34; no. 8; pp. 884 - 892
• Main Authors: Crevat, Denis, Brion, Job D, Gailhardou, Sophia, Laot, Thelma M, Capeding, Maria Rosario
• Format: Journal Article
• Language: English
• Published: United States 01-08-2015
• Subjects: Antibodies, Bacterial - blood; Antibodies, Viral - blood; Dengue; Dengue Vaccines - administration & dosage; Dengue Vaccines - adverse effects; Dengue Vaccines - immunology; Female; Humans; Immunization Schedule; Infant; Male; Measles-Mumps-Rubella Vaccine - administration & dosage; Measles-Mumps-Rubella Vaccine - adverse effects; Measles-Mumps-Rubella Vaccine - immunology; Viremia
• ISSN: 0891-3668; 1532-0987
• DOI: 10.1097/INF.0000000000000752

Dengue is a major public health concern in pediatric populations in endemic regions. A recombinant, live, attenuated, tetravalent dengue vaccine (CYD-TDV) is under development for the control of dengue with a 3-dose (0-6-12 month) vaccination schedule.
In this controlled phase II trial conducted in the Philippines, 210 toddlers aged 12-15 months were randomized to 4 groups: 3 groups received the CYD-TDV vaccination schedule and a measles, mumps and rubella (MMR) vaccine given either concomitantly with the first CYD-TDV dose or 1 month earlier; 1 group received 3 active control vaccines. Safety and reactogenicity were assessed after each dose. Immunogenicity was assessed 30 days after vaccinations using the plaque reduction neutralization test against dengue and enzyme-linked immunosorbent assay methods against MMR antigens.
Injection site and systemic reactions occurred at similar rates across CYD-TDV groups, except for fever, which was more frequent after CYD-TDV and MMR coadministration (28.8%) compared with other groups (12-20%). Reactogenicity did not increase with subsequent CYD-TDV injections. There were no safety issues with the study vaccine. CYD-TDV achieved a balanced antibody response to all 4 dengue serotypes across the study groups, with geometric mean titers in the range of 105-124, 147-213, 311-387 and 127-160 for serotypes 1, 2, 3 and 4, respectively. CYD-TDV coadministration did not affect MMR immunogenicity (≥95% seroprotection against MMR) and vice versa.
The CYD-TDV has an acceptable safety and immunogenicity profile in toddlers and when coadministered with MMR.