Dengue vaccine

Dengue vaccine is a vaccine to prevent dengue fever in humans. The development of vaccine for dengue fever began as early as 1929 but has been hindered by incomplete knowledge of the disease pathogenesis and by the need to simultaneously create a stable immunity against all four dengue serotypes. Several vaccine candidates are in development including live attenuated, inactivated, DNA and subunit vaccines. Two studies of a vaccine in 2014 and 2015 found it was 60% effective and prevented more than 80 to 90% of severe cases.[1][2] It is hoped that the first products will be commercially available by 2015.[3]

Sanofi Pasteur vaccine

The vaccine (YF-VAX) is based on a chimeric virus, which was derived from yellow fever vaccine attenuated strain 17D by replacing its PrM (pre-membrane) and E (envelop) structural genes with those from each of four dengue serotypes.[4][5] The vaccine was safe and immunogenic in animal models and in the phase I, IIa human clinical trials.[5] The vaccination series consists of three injections at 0, 6 and 12 months.[5]

However, in the phase IIb trial in Thailand the vaccine was only 30.2% efficient in prevention of infection. This was mainly due to the lack of protection against DENV-2 serotype, which dominated during the trial.[5]

In a phase III clinical trial conducted in Asia and completed in 2014 its overall efficiency was 56%. The serotype specific efficiency was about 54.5%, 34.7%, 65.2% and 72.4% for DENV-1, DENV-2, DENV-3 and DENV-4, respectively in patients who received at least one injection of the vaccine. The vaccine reduced by about 80% the number of severe dengue cases.[6][7]

In another phase III trial conducted in South America and completed in 2014 the overall vaccine efficiency was 60.8%. The serotype specific efficiency was about 50.3%, 42.3%, 74.0% and 77.7% for DENV-1, DENV-2, DENV-3 and DENV-4, respectively. As in the first trial the vaccine reduced the number of severe dengue cases by about 80%.[8]

References

  1. ↑ Villar, Luis; Dayan, Gustavo Horacio; Arredondo-García, José Luis; Rivera, Doris Maribel; Cunha, Rivaldo; Deseda, Carmen; Reynales, Humberto; Costa, Maria Selma; Morales-Ramírez, Javier Osvaldo; Carrasquilla, Gabriel; Rey, Luis Carlos; Dietze, Reynaldo; Luz, Kleber; Rivas, Enrique; Montoya, Maria Consuelo Miranda; Supelano, Margarita Cortés; Zambrano, Betzana; Langevin, Edith; Boaz, Mark; Tornieporth, Nadia; Saville, Melanie; Noriega, Fernando (3 November 2014). "Efficacy of a Tetravalent Dengue Vaccine in Children in Latin America". New England Journal of Medicine: 141103114505002. doi:10.1056/NEJMoa1411037.
  2. ↑ Villar, L; Dayan, GH; Arredondo-García, JL; Rivera, DM; Cunha, R; Deseda, C; Reynales, H; Costa, MS; Morales-Ramírez, JO; Carrasquilla, G; Rey, LC; Dietze, R; Luz, K; Rivas, E; Miranda Montoya, MC; Cortés Supelano, M; Zambrano, B; Langevin, E; Boaz, M; Tornieporth, N; Saville, M; Noriega, F; CYD15 Study, Group (8 January 2015). "Efficacy of a tetravalent dengue vaccine in children in Latin America.". The New England journal of medicine 372 (2): 113–23. PMID 25365753.
  3. ↑ WHO (2009) p. 137–146.
  4. ↑ Thisyakorn, U. (2014). "Latest developments and future directions in dengue vaccines". Therapeutic Advances in Vaccines 2 (1): 3–9. doi:10.1177/2051013613507862.
  5. ↑ 5.0 5.1 5.2 5.3 Yauch, Lauren E. (2014). "Dengue Virus Vaccine Development". Advances in Virus Research: 315–372. doi:10.1016/B978-0-12-800098-4.00007-6.
  6. ↑ "The Lancet: World's Most Advanced Dengue Vaccine Candidate Shows Promise in Phase 3 Trial". Science Newsline medicne. 10 July 2014. Retrieved 13 July 2014.
  7. ↑ Capeding, Maria Rosario (2014). "Clinical efficacy and safety of a novel tetravalent dengue vaccine in healthy children in Asia: a phase 3, randomised, observer-masked, placebo-controlled trial". The Lancet. doi:10.1016/S0140-6736(14)61060-6.
  8. ↑ "Sanofi Pasteur's dengue vaccine candidate successfully completes final landmark phase III clinical efficacy study in Latin America". Sanofi Pasteur. 3 September 2014. Retrieved 3 September 2014.