Safety of dengue vaccine (CYD-TDV) in Asia: a systematic review

Abstract

The use of the vaccine in Asia is still very much limited and remained controversial due to its safety, which has yet been properly assessed and evaluated. Hence, the objective of this review is to assess the safety of the CYD-TDV dengue vaccine of the efficacy trials conducted in Asia. A total of 309 related articles were generated from the electronic database search using relevant keywords and only four of the articles were selected for the final review process. The seroprevalence at baseline of the participants involved in the studies was between 50 percent and 80 percent. In terms of the safety of the CYD-TDV vaccine, injection site reaction (pain, swelling, erythema) recorded a relative risk (RR) at 95% CI of (0.46—1.76) and systemic reactions (fever, headache, myalgia) also with RR at 95% CI of (0.89—1.81) were detected among the participants. Among the four studies reviewed, three studies reported some severe adverse effect experienced by the participants with RR at 95% CI of (0.92—2.11). In terms of the immunogenicity, high GMT values were reported for DENV-2 at 67.8 (95%CI of 64.8-70.8), DENV-3 at 73.1 (95% CI of 69.9-76.3) and DENV-4 at 65 (95%CI of 62-67.9) where even though lower values were reported it is consistent with other published studies on the immunogenicity of the CYD-TDV against the DENV serotypes. This review showed that the CYD-TDV can be considered for use in Asia, but with several conditions and following current safety recommendations.