Vaccination against dengue fever for travellers: Statement of the Swiss Expert Committee for Travel Medicine, an organ of the Swiss Society for Tropical and Travel Medicine, August 2024 (original) (raw)
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Review article: Medical guidelines
- Olivia Veit
- Pietro Antonini
- Jan Fehr
- Sabine Haller
- Christoph Hatz
- Pierre Landry
- Andreas Neumayr
- Anita Niederer-Lohrer
- Patricia Schlagenhauf
- Serge de Vallière
- Cornelia Staehelin
- on behalf of the Swiss Expert Committee on Travel Medicine (ECTM)
Summary
Dengue fever, endemic to most tropical and subtropical countries, is a major cause of illness in travellers, but severe dengue, hospitalisation and death are considered rare in this population. Two vaccines against dengue fever, Dengvaxia® and Qdenga®, are available. While there is no recommendation for the use of Dengvaxia® in travellers, Qdenga® has been licensed for travellers in many European countries since December 2022, most recently (29 July 2024) in Switzerland by Swissmedic.
The Swiss Expert Committee for Travel Medicine (ECTM), having assessed available data on the Qdenga® vaccine, issues the following recommendations:
(1) Vaccination against dengue fever virus with Qdenga® is not recommended for persons with no previous dengue fever infection.
(2) Vaccination with Qdenga® may be recommended for travellers aged 6 years and older who have evidence of previous dengue infection, defined as (a) a laboratory-confirmed dengue infection (PCR, antigen or seroconversion) or (b) a compatible history of dengue infection with a positive IgG serological test AND expected exposure to a region with significant dengue transmission.
Travel medicine advisors should provide clear information in accessible language on the complexity of dengue vaccines and the risk/benefit evaluation for their use in travellers.
References
- WHO. Dengue- Global situation. 2023. Available from: https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON498
- PAHO/WHO Data - Dengue. Available from: https://www3.paho.org/data/index.php/en/mnu-topics/indicadores-dengue-en.html
- Yang X, Quam MB, Zhang T, Sang S. Global burden for dengue and the evolving pattern in the past 30 years. J Travel Med. 2021 Dec;28(8):taab146. doi: https://doi.org/10.1093/jtm/taab146DOI: https://doi.org/10.1093/jtm/taab146
- ECDC. Autochthonous vectorial transmission of dengue virus in mainland EU/EEA, 2010-present. 2023. Available from: https://www.ecdc.europa.eu/en/all-topics-z/dengue/surveillance-and-disease-data/autochthonous-transmission-dengue-virus-eueea
- CDC. Centers for Disease Control and Prevention. 2024. Dengue areas of risk in the US | CDC. Available from: https://www.cdc.gov/dengue/areaswithrisk/in-the-us.html
- Halstead S, Wilder-Smith A. Severe dengue in travellers: pathogenesis, risk and clinical management. J Travel Med. 2019 Oct;26(7):taz062. doi: https://doi.org/10.1093/jtm/taz062DOI: https://doi.org/10.1093/jtm/taz062
- Huits R, Angelo KM, Amatya B, Barkati S, Barnett ED, Bottieau E, et al. Clinical Characteristics and Outcomes Among Travelers With Severe Dengue: A GeoSentinel Analysis. Ann Intern Med. 2023 Jul;176(7):940–8. doi: https://doi.org/10.7326/M23-0721
- Duvignaud A, Stoney RJ, Angelo D O KM, Chen LH, Cattaneo P, Motta L, et al.; GeoSentinel Network. Epidemiology of Travel-Associated Dengue from 2007 to 2022: A GeoSentinel Analysis. J Travel Med. 2024 Jul;2:taae089. doi: https://doi.org/10.1093/jtm/taae089DOI: https://doi.org/10.1093/jtm/taae089
- Guo C, Zhou Z, Wen Z, Liu Y, Zeng C, Xiao D, et al. Global Epidemiology of Dengue Outbreaks in 1990-2015: A Systematic Review and Meta-Analysis. Front Cell Infect Microbiol. 2017 Jul;7:317. doi: https://doi.org/10.3389/fcimb.2017.00317DOI: https://doi.org/10.3389/fcimb.2017.00317
- WHO position paper on dengue vaccines – 2024. Report No.: WER9918. Available from: https://iris.who.int/handle/10665/376641?search-result=true&query=&scope=&filtertype_0=relationserie&filter_relational_operator_0=contains&filter_0=Weekly+Epidemiological+Record&rpp=10&sort_by=dc.date.issued_dt&order=desc&page=3
- Ooi EE, Kalimuddin S. Insights into dengue immunity from vaccine trials. Sci Transl Med. 2023 Jul;15(704):eadh3067. doi: https://doi.org/10.1126/scitranslmed.adh3067DOI: https://doi.org/10.1126/scitranslmed.adh3067
- Schmidt AC. Response to dengue fever — the good, the bad, and the ugly? N Engl J Med. 2010 Jul;363(5):484–7. doi: https://doi.org/10.1056/NEJMcibr1005904DOI: https://doi.org/10.1056/NEJMcibr1005904
- Halstead SB, Dans LF. Dengue infection and advances in dengue vaccines for children. Lancet Child Adolesc Health. 2019 Oct;3(10):734–41. doi: https://doi.org/10.1016/S2352-4642(19)30205-6DOI: https://doi.org/10.1016/S2352-4642(19)30205-6
- Katzelnick LC, Gresh L, Halloran ME, Mercado JC, Kuan G, Gordon A, et al. Antibody-dependent enhancement of severe dengue disease in humans. Science. 2017 Nov;358(6365):929–32. doi: https://doi.org/10.1126/science.aan6836DOI: https://doi.org/10.1126/science.aan6836
- Huits R, Angelo KM, Amatya B, Barkati S, Barnett ED, Bottieau E, et al. Clinical Characteristics and Outcomes Among Travelers With Severe Dengue: A GeoSentinel Analysis. Ann Intern Med. 2023 Jul;176(7):940–8. doi: https://doi.org/10.7326/M23-0721DOI: https://doi.org/10.7326/M23-0721
- WHO Technical Report Series No 932. Guidelines on the quality, safety and efficacy of dengue tetravalent vaccines (live, attenuated). 2011.
- CDC. Dengue. 2024 [cité 10 juill 2024]. About a Dengue Vaccine. Available from: https://www.cdc.gov/dengue/vaccine/index.html
- Capeding MR, Tran NH, Hadinegoro SR, Ismail HI, Chotpitayasunondh T, Chua MN, et al.; CYD14 Study Group. 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. 2014 Oct;384(9951):1358–65. doi: https://doi.org/10.1016/S0140-6736(14)61060-6DOI: https://doi.org/10.1016/S0140-6736(14)61060-6
- Villar L, Dayan GH, Arredondo-García JL, Rivera DM, Cunha R, Deseda C, et al.; CYD15 Study Group. Efficacy of a tetravalent dengue vaccine in children in Latin America. N Engl J Med. 2015 Jan;372(2):113–23. doi: https://doi.org/10.1056/NEJMoa1411037DOI: https://doi.org/10.1056/NEJMoa1411037
- Sridhar S, Luedtke A, Langevin E, Zhu M, Bonaparte M, Machabert T, et al. Effect of Dengue Serostatus on Dengue Vaccine Safety and Efficacy. N Engl J Med. 2018 Jul;379(4):327–40. doi: https://doi.org/10.1056/NEJMoa1800820DOI: https://doi.org/10.1056/NEJMoa1800820
- de Silva A, White L. Immunogenicity of a Live Dengue Vaccine (TAK-003). J Infect Dis. 2022 Dec;227(1):163–4. doi: https://doi.org/10.1093/infdis/jiac424DOI: https://doi.org/10.1093/infdis/jiac424
- Takeda Announces Withdrawal of U.S. BLA for Dengue Vaccine Candidate. Available from: https://www.takeda.com/newsroom/statements/2023/takeda-announces-voluntary-withdrawal-of-US-biologics-license-application-for-dengue-vaccine-candidate-TAK-003/
- Tian Y, Grifoni A, Sette A, Weiskopf D, Human T. Human T Cell Response to Dengue Virus Infection. Front Immunol. 2019 Sep;10:2125. doi: https://doi.org/10.3389/fimmu.2019.02125DOI: https://doi.org/10.3389/fimmu.2019.02125
- Petri E, Biswal S, Lloyd E, Tricou V, Folschweiller N. Early Onset of Protection of the TAK-003 Dengue Vaccine . CISTM18 [Abstract], 2023. Available from: https://www.istm.org/wp-content/uploads/cistm18_abstract_book_12_june-2023_update-1.pdf
- Biswal S, Reynales H, Saez-Llorens X, Lopez P, Borja-Tabora C, Kosalaraksa P, et al.; TIDES Study Group. Efficacy of a Tetravalent Dengue Vaccine in Healthy Children and Adolescents. N Engl J Med. 2019 Nov;381(21):2009–19. doi: https://doi.org/10.1056/NEJMoa1903869DOI: https://doi.org/10.1056/NEJMoa1903869
- Tricou V, Yu D, Reynales H, Biswal S, Saez-Llorens X, Sirivichayakul C, et al. Long-term efficacy and safety of a tetravalent dengue vaccine (TAK-003): 4·5-year results from a phase 3, randomised, double-blind, placebo-controlled trial. Lancet Glob Health. 2024 Feb;12(2):e257–70. doi: https://doi.org/10.1016/S2214-109X(23)00522-3DOI: https://doi.org/10.1016/S2214-109X(23)00522-3
- Rivera L, Biswal S, Sáez-Llorens X, Reynales H, López-Medina E, Borja-Tabora C, et al. Three-year Efficacy and Safety of Takeda’s Dengue Vaccine Candidate (TAK-003). Clin Infect Dis. 2022 Aug;75(1):107–17. doi: https://doi.org/10.1093/cid/ciab864DOI: https://doi.org/10.1093/cid/ciab864
- Chan KR, Ismail AA, Thergarajan G, Raju CS, Yam HC, Rishya M, et al. Serological cross-reactivity among common flaviviruses. Front Cell Infect Microbiol. 2022 Sep;12:975398. doi: https://doi.org/10.3389/fcimb.2022.975398DOI: https://doi.org/10.3389/fcimb.2022.975398
- Rathore AP, St John AL. Cross-Reactive Immunity Among Flaviviruses. Front Immunol. 2020 Feb;11:334. doi: https://doi.org/10.3389/fimmu.2020.00334DOI: https://doi.org/10.3389/fimmu.2020.00334
- Köpke C, Schneitler S. First clinical experiences with the Qdenga® vaccine in Germany: a multicentric TravelMedVac study. Presented as Free Communication at the Northern European Conference on Travel Medicine (NECTM9), Copenhagen, Denmark, May 22-24, 2024.
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