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Dengue Vaccine for those who have had Dengue before: Dengvaxia

November 14th, 2017
Dengue vaccine mosquito

 

  • Dengvaxia is a Dengue vaccine. This vaccine will protect against second attacks of Dengue Fever.
  • 3 doses are necessary: given at 0, then 6 months later, then 12 months after the first dose.

Dengue fever is common in the tropics

  • The global incidence of dengue has grown dramatically in recent decades. About half of the world’s population is now at risk. Dengue is found in tropical and sub-tropical areas worldwide, mostly in urban and semi-urban areas.

Second attacks of Dengue Fever are often worse than the first attack

  • There are four strains of the Dengue Virus. Each strain is quite distinct, so it is possible to catch Dengue fever four times.
  • After the first attack of Dengue, an individual is immune to that particular strain of dengue for their lifetime. However, if that person then catches a different strain of Dengue, the different strain is more dangerous and can lead to hospitalisation or even death. Some people get no symptoms during the first or even subsequent attacks of the Dengue virus.
  • Most currently available tests cannot determine which strain of Dengue a person has contracted. There is no map showing which strains occur in which countries; in all likelihood, most strains occur in most at-risk countries.

Who might benefit from Dengue Vaccine?

  • A rough rule of thumb is that this vaccine is recommended for persons aged 18-60 years of age, who have had Dengue, and will spend 3 months or more over the next 5 years, in Dengue risk areas.
  • Dengvaxia can protect persons who have already had one attack of Dengue from getting subsequent attacks of Dengue fever – which may be more severe.
  • Dengvaxia is only given to persons who have definitely had Dengue fever before, confirmed by blood test.
  • Severe Dengue fever is more common in persons who had a different strain of Dengue many years previously (compared to a year ago).

Some people cannot have this Dengue Vaccine

  • Persons who have never had Dengue fever before.
  • Dengvaxia is a live vaccine, (like Measles vaccine) so it is not suitable for person with immune system issues
    • Those with HIV / AIDS
    • Those with congenital immune problems
    • Pregnant or breastfeeding women
    • Those on treatment with blood products or immunoglobulins
    • Those taking immune suppressive medications such as high dose steroids.

Potential side effects from the vaccine

  • Very common side effects (>10%) are headache, muscle aches, fatigue, injection site pain, fever.
  • Common side effects (1-10%) are injection site redness, swelling,
  • Uncommon side effects (<1% ) swelling lymph nodes, cough/runny nose/sore throat, rash, joint pain, dizziness, migraine
  • Vaccination should be ideally given 12 months prior to departure to risk areas to allow time for the course to be completed, but having the vaccine does not mean you cannot travel during the course.
  • Vaccination is not 100% effective: data suggests the effectiveness of the vaccine against confirmed severe dengue illness was 93.2% (95% CI 77.3%–98.0%) among participants ≥ 9 years.
  • The duration of protection is currently still being determined but there is no recommendation for a booster.

Dengue vaccine is not openly registered in Australia

Dengvaxia (the Dengue vaccine) is not openly registered in Australian, and thus “has not been evaluated for quality, safety and efficacy in the Australian context”. The vaccine is available on the special access scheme for patients who would benefit from the vaccine. Patients who have had Dengue fever in the past should discuss this vaccine with our doctors, ideally well in advance of departure.

Further reading

SBS news report Dengvaxia

Support from Public Health Association

Early news reports: vaccine for Brazil

 

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