Orellano Pablo W, Salomón Oscar D
Universidad Tecnológica Nacional, Facultad Regional San Nicolás, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina. E-mail:
Instituto Nacional de Medicina Tropical (INMeT), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Puerto Iguazú, Misiones, Argentina.
Medicina (B Aires). 2016;76(2):98-102. Epub 2016 Mar 2.
Dengue outbreaks have occurred yearly in Argentina since 1998. A number of candidate vaccines have been tested in endemic countries. The most advanced one was licensed in three countries of Latin America for children over 9 years of age. In the present article the benefits and drawbacks of these vaccines as well as the challenges for the implementation of a vaccination strategy in Argentina are discussed. Furthermore, a risk stratification strategy with new criteria and a multidisciplinary vision is suggested as a possible path for the assessment of the pertinence of a vaccination program in areas showing the highest risk of dengue transmission and/or for people at the greatest risk of developing severe dengue. It is also suggested that the definition regarding the status of endemicity should take into account the local realities. Finally, this paper proposes a broad discussion on the evidences, the expected impact and instrumental aspects that would be involved in the incorporation of a dengue vaccine, marketed or in development, into the national immunization program, and especially which subpopulation should be targeted for the immunization strategy to be cost-effective.
自1998年以来，阿根廷每年都会爆发登革热疫情。一些候选疫苗已在流行国家进行了测试。最先进的一种已在拉丁美洲的三个国家获得许可，用于9岁以上儿童。在本文中，讨论了这些疫苗的优缺点以及在阿根廷实施疫苗接种策略所面临的挑战。此外，还建议采用一种具有新标准和多学科视角的风险分层策略，作为评估登革热传播风险最高地区和/或患严重登革热风险最大人群的疫苗接种计划相关性的可能途径。还建议关于地方性流行状态的定义应考虑当地实际情况。最后，本文提议就将市售或正在研发的登革热疫苗纳入国家免疫规划所涉及的证据、预期影响和工具性方面进行广泛讨论，特别是为使免疫策略具有成本效益，应针对哪些亚人群进行免疫接种。
