Dengvaxia sensitizes seronegatives to vaccine enhanced disease regardless of age

Vaccine. 2017 Nov 7;35(47):6355-6358. doi: 10.1016/j.vaccine.2017.09.089. Epub 2017 Oct 10.


During a large scale clinical efficacy trial of the Sanofipasteur live-attenuated tetravalent dengue vaccine (Dengvaxia), features of hospitalized disease accompanying dengue infections in placebo recipients were closely similar to those in vaccinated children. However, the age specific hospitalization curves for these two populations differed. The curve for children vaccinated at ages 2-16 years closely resembled the 1981 age specific hospitalization rate curve for Cuban children infected with DENV 2 who were sensitized by a prior DENV 1 infection. The corresponding age specific hospitalization curve for placebos experiencing heterotypic secondary dengue infections peaked at age, 9-11 years. These differing epidemiological features support the conclusion that antibody dependent enhanced (ADE) dengue disease occurred in seronegatives who were sensitized by vaccine. As hospitalizations continue to occur in all age groups Dengvaxia consumers should be warned that sensitized vaccinated seronegatives will experience enhanced dengue disease into the forseeable future.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antibody-Dependent Enhancement*
  • Child
  • Child, Preschool
  • Dengue / chemically induced*
  • Dengue / prevention & control*
  • Dengue Vaccines / administration & dosage*
  • Dengue Vaccines / adverse effects*
  • Female
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Placebos / administration & dosage
  • Treatment Outcome
  • Vaccines, Attenuated / administration & dosage
  • Vaccines, Attenuated / adverse effects
  • Young Adult


  • Dengue Vaccines
  • Placebos
  • Vaccines, Attenuated