Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States.
Curr Opin Virol. 2020 Aug;43:79-87. doi: 10.1016/j.coviro.2020.09.005. Epub 2020 Oct 23.
Dengue is the most important arboviral disease world-wide with an estimated 400 million annual infections. Dengvaxia™ is a live attenuated tetravalent vaccine recently licensed for dengue seropositive individuals aged 9-45 years. There is great need for a dengue vaccine that could be given to dengue-naïve individuals and very young children. To that end, the U.S. NIH developed a live attenuated tetravalent dengue vaccine using an iterative approach evaluating the safety, infectivity, and immunogenicity of different candidates. This approach identified poor candidates who were then discarded from further evaluation. Each of the components of the tetravalent vaccine formulation is able to replicate to very low titer, inducing a homotypic immune response to each. The immune response elicited by the tetravalent vaccine is balanced, without immunodominance of one component. The vaccine was licensed by several manufacturers for development, including the Instituto Butantan which initiated a Phase 3 efficacy trial.
登革热是全球最重要的虫媒病毒病之一，估计每年有 4 亿例感染。登革热疫苗（Dengvaxia™）是一种最近获得许可的四价减毒活疫苗，适用于 9-45 岁登革热血清阳性个体。非常需要一种可以用于登革热初发个体和非常年幼儿童的登革热疫苗。为此，美国国立卫生研究院（NIH）采用迭代方法开发了一种四价减毒活疫苗，评估不同候选疫苗的安全性、传染性和免疫原性。这种方法确定了较差的候选疫苗，然后将其从进一步评估中剔除。四价疫苗配方的每个成分都能够以非常低的滴度复制，诱导针对每种成分的同型免疫反应。四价疫苗引起的免疫反应是平衡的，没有一种成分的免疫优势。该疫苗已被几家制造商获得许可进行开发，包括布坦坦研究所（Instituto Butantan），该机构启动了一项 3 期疗效试验。
