Deliberations of the Strategic Advisory Group of Experts on Immunization on the use of CYD-TDV dengue vaccine

被引:116
作者
Wilder-Smith, Annelies [1 ]
Hombach, Joachim [1 ]
Ferguson, Neil [2 ]
Selgelid, Michael [3 ]
Brien, Kate O. [4 ]
Vannice, Kirsten [1 ]
Barrett, Alan [5 ]
Ferdinand, Elizabeth [6 ]
Flasche, Stefan [7 ]
Guzman, Maria [8 ]
Novaes, Hillegonde Maria [9 ]
Ng, Lee-Ching [10 ]
Smith, Peter G. [7 ]
Tharmaphornpilas, Piyanit [11 ]
Yoon, In-Kyu [12 ]
Cravioto, Alejandro [13 ]
Farrar, Jeremy [14 ]
Nolan, Terry M. [15 ]
机构
[1] WHO, Initiat Vaccine Res, CH-1211 Geneva, Switzerland
[2] Imperial Coll, Dept Infect Dis Epidemiol, London, England
[3] Monash Univ, WHO, Collaborating Ctr Bioeth, Monash Bioeth Ctr, Melbourne, Vic, Australia
[4] Johns Hopkins Bloomberg Sch Publ Hlth, Int Vaccine Access Ctr, Baltimore, MD USA
[5] Univ Texas Med Branch, Galveston, TX 77555 USA
[6] Univ West Indies, Fac Med Sci, Bridgetown, Barbados
[7] London Sch Hyg & Trop Med, Dept Infect Dis Epidemiol, London, England
[8] Pedro Kouri Trop Med Inst, Havannah, Cuba
[9] Univ Sao Paulo, Fac Med Sci, Sao Paulo, Brazil
[10] Natl Environm Agcy, Environm Hlth Inst, Singapore, Singapore
[11] Minist Publ Hlth, Bangkok, Thailand
[12] Int Vaccine Inst, Seoul, South Korea
[13] Univ Nacl Autonoma Mexico, Fac Med, Mexico City, DF, Mexico
[14] Wellcome Trust Res Labs, London, England
[15] Univ Melbourne, Sch Populat & Global Hlth, Melbourne, Vic, Australia
基金
英国医学研究理事会; 英国惠康基金;
关键词
RECOMMENDATIONS; EFFICACY; CHILDREN;
D O I
10.1016/S1473-3099(18)30494-8
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
The Strategic Advisory Group of Experts (SAGE) on Immunization advises WHO on global policies for vaccines. In April, 2016, SAGE issued recommendations on the use of the first licenced dengue vaccine, CYD-TDV. In November, 2017, a retrospective analysis of clinical trial data, stratifying participants according to their dengue serostatus before the first vaccine dose, showed that although in high seroprevalence settings the vaccine provides overall population benefit, there was an excess risk of severe dengue in seronegative vaccinees. SAGE's working group on dengue vaccines met to discuss the new data and mainly considered two vaccination strategies: vaccination of populations with dengue seroprevalence rates above 80% or screening of individuals before vaccination, and vaccinating only seropositive individuals. We report on the deliberations that informed the recommendation of the pre-vaccination screening strategy, in April, 2018. Important research and implementation questions remain for CYD-TDV, including the development of a highly sensitive and specific rapid diagnostic test to determine serostatus, simplified immunisation schedules, and assessment of the need for booster doses.
引用
收藏
页码:E31 / E38
页数:8
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