One of the lessons learned in the field of vaccine introduction is that developing countries receive access to new vaccine far after developed countries. DVI believes that early preparation of introduction, good planning and management, and collaboration between developing countries could accelerate introduction. The Consolidated Points for Consideration provides a framework for helping countries interested in being among the first to introduce a dengue vaccine to consider the elements needed for vaccine introduction, and to plan and start preparation in a timely manner. DVI, members of the Dengue Prevention Board (DPB) and other representatives from countries have examined multiple aspects of vaccine introduction and have sponsored studies and analysis. The DPB, one in the Asia-Pacific and the second in the Americas, met last year to lay out, and then build on, points for consideration to help countries determine if they wish to be among those to first adopt a dengue vaccine. The Consolidated Points for Consideration is a consolidation and elaboration of the points developed in these meetings, and incorporates inputs from a wide range of those involved in dengue and dengue vaccines. It also includes an extensive and carefully selected list of relevant references that provide additional information and guidance.
Dengue is a potentially fatal viral disease for which treatment is limited to supportive care, and prevention and control are based on mosquito vector control programs. It is the fastest growing arboviral infection and is currently endemic in more than 100 tropical and subtropical countries, placing over 40% of the world's population at risk. At least 50 million infections are thought to occur annually, resulting in approximately 500 000 hospitalizations, mainly in children. In the context of an expanding and potentially fatal infectious disease without effective prevention or specific treatment, the public health value of a protective vaccine is clear. This review considers some of the challenges to dengue vaccine development, and in particular the challenges of demonstrating dengue vaccine efficacy. [Abstract from Science Direct]
During the past ﬁve decades, the incidence of dengue has increased 30-fold. Some 50–100 million new infections are estimated to occur annually in more than 100 endemic countries, with a documented further spread to previously unaffected areas; every year hundreds of thousands of severe cases arise, including 20 000 deaths; 264 disability-adjusted life years per million population per year are lost , at an estimated cost for ambulatory and hospitalized cases of US$ 514–1394, often affecting very poor populations. The true numbers are probably far worse, since severe underreporting and misclassiﬁcation of dengue cases have been documented.