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Healio could not confirm any relevant financial information for Esquiline and Maldonado at the time of publication. Atmar does not report any relevant financial information.
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The Advisory Committee on Vaccination Practices has unanimously recommended, by 14 votes to 0, the use of an approved three-dose dengue vaccine for children aged 9-16 living in endemic areas.
The ACIP also recommended covering the vaccine under the Vaccines for Children (VFC) program for those with laboratory-confirmed previous dengue infections living in endemic areas with a unanimous 14-0 vote.
Source: Adobe Stock.
Dengvaxia (CYD-TDV, Sanofi Pasteur) was approved by the FDA in May 2019 for children ages 9-16 living in endemic areas, including Puerto Rico, which had higher levels of dengue fever last year. The three doses should be given 6 months apart.
The vaccine protects against diseases caused by all four dengue serotypes and is only approved for children with laboratory confirmation of previous dengue infection, as the vaccine can act like an initial dengue infection, putting the child at risk for serious illness if acquired later would naturally expose an infection.
Dengue has been endemic to Puerto Rico for about 50 years, according to the ACIP Dengue Vaccine Working Group. It infects approximately 60% of the population in the second decade of life and 80% in the third decade of life.
To get a vaccine, a person must test positive for dengue antibodies, but there are only two diagnostic tests available commercially to test for the presence of dengue antibodies, and none have been approved by the FDA Robert Atmar, MD, Professor of Infectious Diseases at Baylor College of Medicine.
In Puerto Rico, tests must be performed by a certified lab technician in a commercial laboratory, but as of March 2020, there were only two such locations on the island.
Although the vaccine is covered by the VFC program, the diagnostic test to confirm whether a person has dengue antibodies is not. However, the tests could be covered by insurance, Atmar said in an earlier interview.
Ines O. Esquiline, MD, a pediatric ID specialist in San Juan, Puerto Rico, gave a presentation on the acceptance of Dengvaxia across Puerto Rico.
In a rating of 1,082 adults from November 2020 to June 2021, Esquiline reported that 84% of people said they received the dengue vaccine themselves, while 83% said they would feel comfortable vaccinating their child.
However, 11% of participants said they would neither receive the vaccine themselves nor allow their children to receive it. Esquiline reported that all respondents had concerns about the safety of the vaccine.
Yvonne A. Maldonado, MD, FAAP, Chairman of the AAP’s Infectious Diseases Committee and Professor and Head of the Infectious Diseases Department at Stanford University School of Medicine, attended and gave an outlook from the academy.
“COVID-19 taught us one thing, and that is that you have to weigh the risks and benefits,” Maldonado said during the meeting. “I understand that taking risks sounds uncomfortable, but the risks here are actually extremely manageable, although there will be a number of administrative obstacles to overcome … Dengue is clearly a critical issue that has emerged over the years, particularly in tropical areas.” . “
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