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Update on Dengue Vaccines
Joshua Wong, MD
Medical Officer | NCEZID/DVBD/Dengue Branch
Meeting of the Advisory Committee on Immunization Practices
June 26, 2024National Center for Emerging and Zoonotic Infections
1
Dengue Epidemiology Globally
Countries reporting locally acquired dengue cases,
March 2023 –April 2024
Image from: https://www.ecdc.europa.eu/en/publications -data/countriesterritories -reporting -dengue -cases -march -2023 -and-april -2024 . Accessed 6/1/2024
Dengue cases in the Americas, 1980 –2024
Nearly 10 million cases reported in 2024 as of June 25.
Data from PAHO PLISA Health Information Platform for the Americas. https://www3.paho.org/data/index.php/es/temas/indicadores -dengue.html . Accessed 6/25/202402,000,0004,000,0006,000,0008,000,00010,000,00012,000,000Number of dengue cases
Year
Dengue Epidemiology in the U.S.
In the United States, dengue is endemic in
6U.S. territories and freely associated states.
Puerto Rico declared a public health emergency
due to a dengue epidemic in March 2024.
Weekly Arboviral Report – Week 23, Puerto Rico Department of Health, accessed 6/25/2024. https://www.salud.pr.gov/CMS/DOWNLOAD/9050
2023 cases 2024 cases Historic median Epidemic thresholdDENV infections in
Puerto Rico have
been above the
epidemic threshold
for 21 weeks.x 21 weeksNumber of cases
Week
Update on Dengvaxia in Puerto Rico
The first dengue
vaccine in Puerto
Rico was
administered on
September 7,
2022.
Images from: https://www.elvocero.com/actualidad/salud/administran -la-primera -vacuna -contra -el-
dengue/article_9c49436a -2e4f -11ed -beba -0bf2bccaeb1f.html Accessed 6/12/2024.
Since Dengvaxia vaccination began in Puerto Rico,
264 doses have been administered.*
13149264
050100150200250300
1 2 3Number of Doses of Dengvaxia
Administered (cumulative)
Year
Data used with permission from the Puerto Rico Department of Health, Vaccine Program. Current as of June 24, 2024.
Since Dengvaxia vaccination began in Puerto
Rico, 145 individuals have started the series.
145
87
32
020406080100120140160
1 2 3Number of Doses of Dengvaxia
Administered (cumulative)
Data used with permission from the Puerto Rico Department of Health, Vaccine Program. Current as of June 24, 2024.
Physician visit #1:
Initial evaluationLaboratory
testingPhysician visit #2:
Results follow -upVaccine clinic visit
Schedule 2nd and 3rd dosesMultiple visits to healthcare providers to determine eligibility
and start vaccination has complicated implementation.
Major barriers to uptake have included:
Prevaccination
Testing
Limited vaccine
messaging
Complex billing
processes
CDC has updated its website with information
on discontinuation of Dengvaxia.
Dengue Vaccine | Dengue | CDC
Update on Other Dengue Vaccines in the U.S.
Takeda voluntarily withdrew TAK -003 (Qdenga) from
FDA review in July 2023.
Takeda/Newsroom
The TV003/TV005 dengue vaccine is in late-stage
phase 3 trials.
•Developed by the US National Institutes of Health (NIH).
•Licensed to Merck in the U.S. and the Instituto Butantan in
Brazil.
•Phase 3 trials in Brazil are ongoing.
•High efficacy and safety results during the first two year
follow -up period have been published.*
•DENV -3 or DENV -4 not observed during this period,
limiting evaluation of VE against these serotypes.
•Five year follow -up data expected later this year.
*Kallás , E. G., et al. (2024). "Live, Attenuated, Tetravalent Butantan -Dengue Vaccine in Children and Adults." N Engl J Med 390(5): 397 -408.
Image from: https://revistapesquisa.fapesp.br/en/butantans -dengue -vaccine -is-80-effective/ accessed 6/11/2024.
No dengue vaccines will be available in the
U.S. after the discontinuation of Dengvaxia.
•No dengue vaccines are currently under
review by FDA.
•The ACIP Dengue Vaccines Workgroup
group will be paused until new dengue
vaccines are submitted to FDA for
approval.
Conclusion
•Dengue cases globally are increasing.
•Puerto Rico has declared a public health emergency due to the
dengue epidemic.
•There will be no other vaccines available in the U.S. after
Dengvaxia manufacturing is discontinued.
•The Dengue Vaccines Workgroup will be paused until new
vaccines are submitted for FDA review.
•Vaccines are just one part of a multilayered approach to
reducing morbidity by dengue.
For more information, contact CDC
1-800-CDC-INFO (232 -4636)
TTY: 1 -888-232-6348 www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the
official position of the Centers for Disease Control and Prevention.
ACIP Members
Wilbur Chen (Chair)
Kathy Poehling
Beth Bell
Veronica McNally
CDC Co -Leads
Gabriela Paz -Bailey
Laura Adams
Ex Officio Members
Kaitlyn Morabito (NIH)
Ralph LeBlanc (FDA)
Ihid Carneiro Leao (FDA)
Kirk Prutzman (FDA)
Srihari Seshadri (DOD)
Liaison Representatives
Elizabeth Barnett (AAP)
Rob Schechter (AIM)Consultants
Edwin Asturias
Robert Atmar
Alan Barrett
Iris Cardona
Anna Durbin
Tony Marfin
Kristen Pierce
Anita Shet
CDC Contributors
Joshua Wong
Nicole Medina
Mimi Eckert
Rachel Eidex
Alfonso Hernandez
Susan Hills
Terri Hyde
Mike McNeil
Jorge MunozErin Staples
Cindy Weinbaum
Rita Helfand
Non -Members
Mitchelle Flores -Febo
Parker Acevedo
Diana Duran
Angel RiveraQuestions?ACIP Dengue Vaccines Workgroup and Support Team