An Updated Comprehensive Review of the Dengue Vaccine: Development, Mechanism, Efficacy, and Safety

Abstract

Dengue virus (DENV) is spread through bites from mosquitos of the Aedes genus. DENV activates antibodies against 4 dengue serotypes, which are identified by the plaque reduction neutralization test of 50%, and the dengue antivirals use nonstructural viral antigens to excite T cells. Dengue vaccines include a live attenuated vaccine, inactivated vaccine, and DNA vaccine, among others. DENV is via dengue enzyme-linked immunosorbent assay (ELISA)-immunoglobulin (Ig). In 2009, the World Health Organization classified patients with DENV according to clinical presentation (dengue fever with rash, headache, eye pain, muscular pain, joint pain, and leukopenia) and positive test results for nonstructural protein 1 and dengue IgM antibodies by ELISA. The Dengvaxia vaccine is in second phase III trials; it was released by Sanofi Pasteur for use in Mexico in 2015 and was being used in more than 20 countries by 2017. After 30 years of research, only the live attenuated vaccine has passed phase III trials. Clinical trials for treating infections with Flavivirus viruses have been conducted in Asia and North and South America. Phase I to phase III trials involving 40,000 volunteers from 16 countries have assessed the vaccine safety, immunogenicity, and protection.