Tracking Dengvaxia, Qdenga (TAK-003) & Tetravalent Dengue Vaccines
Dengue infects 390 million people annually across 129 countries, causing 40,000 deaths. After decades of research, three vaccines are now licensed: Dengvaxia (CYD-TDV) by Sanofi (approved 2015, limited use due to safety concerns in seronegative individuals), Qdenga (TAK-003) by Takeda (approved 2022-2023 in multiple countries), and TV003/TV005 approaches. All target four dengue serotypes (DENV-1, DENV-2, DENV-3, DENV-4). The challenge: antibody-dependent enhancement (ADE) where prior infection or incomplete immunity can worsen subsequent infections. This tracker monitors licensed vaccines, deployment strategies, and next-generation candidates including single-dose tetravalent vaccines.
Developer: Sanofi Pasteur
Platform: Live attenuated tetravalent vaccine (chimeric yellow fever-dengue virus)
Efficacy: 60% overall, variable by serotype (42-78%)
Dosing: Three doses at 0, 6, and 12 months
Challenge: Increased risk of severe dengue in seronegative individuals (those never infected). WHO now recommends only for seropositive individuals aged 9-45.
Status: Licensed in 20+ countries but use limited by safety concerns. Pre-vaccination screening recommended.
Developer: Takeda Pharmaceuticals
Platform: Live attenuated tetravalent vaccine (based on DENV-2 backbone)
Efficacy: 80.2% against hospitalized dengue, 73.3% against symptomatic dengue in Phase 3 trial (TIDES)
Dosing: Two doses, 3 months apart
Breakthrough: Safe in both seronegative and seropositive individuals - no increased risk of severe disease in dengue-naive recipients
Status: Approved in EU (2022), UK (2022), Indonesia (2022), Brazil (2023), Argentina (2023). Rolling out globally. WHO prequalification pending.
Developer: NIH / Butantan Institute (Brazil)
Platform: Live attenuated tetravalent vaccine
Innovation: Single-dose vaccine showing 90% protection in controlled human infection studies
Status: Phase 3 trial (BRAVE) in Brazil with 16,000 participants. Results expected 2024-2025.
Potential: If successful, could be first single-dose dengue vaccine - major improvement over current 2-3 dose schedules.
Developer: Walter Reed Army Institute / Merck
Platform: Tetravalent purified inactivated vaccine (killed virus)
Advantage: No risk of vaccine virus transmission, may be safer in immunocompromised
Status: Phase 2 trials evaluating safety and immunogenicity
Developer: Merck
Platform: Recombinant subunit vaccine using virus-like particles
Status: Early phase trials, tetravalent formulation in development
Dengue vaccine development is uniquely challenging due to antibody-dependent enhancement (ADE): incomplete immunity can make subsequent infections more severe. Four serotypes (DENV-1 through DENV-4) co-circulate, requiring tetravalent vaccines. Dengvaxia's safety issues in seronegative individuals led to WHO restricting its use. Qdenga represents a breakthrough as the first vaccine safe in all populations. The ideal dengue vaccine would provide: single-dose protection, safety in naive and previously infected individuals, balanced immunity against all 4 serotypes, and long-lasting protection. TV003's single-dose approach and strong CHMI data offer hope for achieving these goals.