Uniformed Services University of the Health Sciences, Bethesda, MD, United States.
Vaccine. 2017 Nov 7;35(47):6355-6358. doi: 10.1016/j.vaccine.2017.09.089. Epub 2017 Oct 10.
During a large scale clinical efficacy trial of the Sanofipasteur live-attenuated tetravalent dengue vaccine (Dengvaxia), features of hospitalized disease accompanying dengue infections in placebo recipients were closely similar to those in vaccinated children. However, the age specific hospitalization curves for these two populations differed. The curve for children vaccinated at ages 2-16 years closely resembled the 1981 age specific hospitalization rate curve for Cuban children infected with DENV 2 who were sensitized by a prior DENV 1 infection. The corresponding age specific hospitalization curve for placebos experiencing heterotypic secondary dengue infections peaked at age, 9-11 years. These differing epidemiological features support the conclusion that antibody dependent enhanced (ADE) dengue disease occurred in seronegatives who were sensitized by vaccine. As hospitalizations continue to occur in all age groups Dengvaxia consumers should be warned that sensitized vaccinated seronegatives will experience enhanced dengue disease into the forseeable future.
在赛诺菲巴斯德公司的减毒四价登革热疫苗（Dengvaxia）大规模临床疗效试验期间，安慰剂组登革热感染者的住院疾病特征与接种疫苗儿童的特征非常相似。然而，这两个群体的特定年龄住院曲线不同。2-16 岁接种疫苗的儿童的曲线与 1981 年古巴儿童因先前感染 1 型登革热病毒而感染 2 型登革热病毒的特定年龄住院率曲线非常相似。接受异源二次登革热感染的安慰剂的相应特定年龄住院曲线在 9-11 岁达到高峰。这些不同的流行病学特征支持这样的结论，即抗体依赖性增强（ADE）登革热疾病发生在疫苗致敏的血清阴性者中。由于所有年龄段的住院治疗仍在继续，Dengvaxia 的使用者应被告知，致敏的接种疫苗的血清阴性者在可预见的未来将经历增强的登革热疾病。
