Dengvaxia: live Tetravalent Dengue vaccine

Dengvaxia: live Tetravalent Dengue vaccine

Dengvaxia vaccine is a brand of live attenuated Dengue virus vaccine four strains 1,2,3,4 that is tetravalent vaccine by Sanofi. Dengvaxia vaccine is a sterile lyophilised mixed preparation containing the attenuated strain of dengue 1 to 4 strains. This vaccine is yet approved in few countries in Europe and USA and Africa. Yet many countries have not accepted this vaccine.

How is Dengvaxia vaccine available?

Dengvaxia vaccine is available as lyophilized powder is available in a separate vial. Other vial contains diluent to be mixed with lyophilized powder. The vaccine is in opaque paper packet. It should be stored in the packaging it comes with.

How is Dengvaxia vaccine stored?

The vial containing lyophilized powder should be stored in frozen and the sterile water for dilution is stored at 2-8 degree Celsius. The manufacturer’s guidelines about storage should be followed at all stages of transport and storage.

How is Dengvaxia vaccine prepared?

Dengvaxia vaccine diluent for injection is mixed with lyophilized powder. The needle should be attached to the syringe of sterile water. The water is pushed into the vial of lyophilized powder. The mixture is agitated gently to mix the content. The care should be taken while doing the procedure that sterilizers and disinfectant should not touch the vial. The care should be taken to avoid the needle prick while mixing the contents. The mixture is sucked buck into the syringe.

How the Dengvaxia vaccine can be given?

Dengvaxia vaccine can be given either by intramuscular route. All the safety injection precautions need to be taken while giving injection. The disinfectant applied to skin should be evaporated completely before giving the injection. The disposables after use of injection should be discarded as per biomedical waste management protocols. The vaccine if expired should be discarded and not used. The expired vaccines need to be discarded as per biomedical waste management protocols.

At what age Dengvaxia vaccine is given?

Dengvaxia vaccine is given at age 9 years to 16 years of age in those people who only had dengue had previously. The serological test should be done before administering the dose. The vaccine should be given only those who test serologically positive.

What if someone has missed Dengvaxia vaccine dose?

It should be given as indicated to those between age 9 years to 16 years in endemic area where serological positive test are positive in majority of population. Currently 3 dose schedule is indicated in those who need it. These 3 doses are to be given over 1 year period.

How does Dengvaxia vaccine works?

Dengvaxia vaccine contains live attenuated viruses of dengue strain 1,2,3,4. Live attenuated means these are live virus but they lack capacity to cause disease though they have capacity to infect. When these viruses are injected by vaccine they infect the person who got the injection. They multiply in the body of the host. The immunity of the host recognizes these viruses. The immunity develops mechanism to fight these viruses. In this process the body also develops the memory immunity. When the real infection of these diseases occur the body rapidly increases the immune response and the disease is prevented. This is active form of immunization.

What are the side effects of the Dengvaxia vaccine?

Side effects of Dengvaxia vaccine are usually milder when compared to the diseases it cause. Common side effects are:

  • Fever may come and usually lasts for 1-3 days and it can be easily controlled by oral medications like paracetamol at home.
  • Skin rash which looks like measles disease can appear in few days after vaccination. This rash is usually milder and short lasting than measles disease.
  • Pain, swelling and redness at injection site. This may come after injection and may last for 1-3 days. It usually subsides by its own or by simple measures like local cold fomentation.
  • Headache may occur after the dose of this vaccine which can be mild to moderate grade.
  • Malaise and myalgia may occur after this vaccination usually subsides by own or with paracetamol.
  • Like all other vaccine anaphylaxis reaction may come after this vaccination though it is very rare. The facility at which vaccination is given should be ready to manage the anaphylaxis with necessary equipments and skilled personnel.

What cautions are needed with Dengvaxia vaccine?

  • The facility to management anaphylaxis should be ready while giving this injection.
  • The vaccine should not be given to those who are allergic to any of its components.
  • This is live vaccine so cannot be used in pregnancy..
  • This vaccine should not be given to those who are severe immunocompromised.
  • Those who have HIV AIDS stage 3 and 4 should not be given this vaccine.
  • Biomedical waste management guidelines are to be followed like all other vaccinations.
  • The vaccine is stored as per mentioned on packet by the manufacturer.
  • This vaccine should not be given to those who test negative on serological test for dengue. The serological test Anti dengue IgG ELISA test should be used before giving this vaccine. Use of card test is acceptable in area where in general sero-prevalence is higher.

To whom Dengvaxia vaccine is contraindicated?

  • Dengvaxia vaccine is contraindicated in those with stage 3 or stage 4 HIV AIDS disease.
  • Dengvaxia vaccine is contraindicated those who are severely immunocompromized.
  • Those who are pregnant.
  • Those who are allergic to any of its component.
  • Contraindicated in pregnancy and lactation.
  • Contraindicated in those who test sero-negative on serological tests.

You can read more about vaccination.

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