A systematic review and meta-analysis were performed to assess the efficacy, immunogenicity, and safety of recombinant tetravalent dengue vaccine (CYD-TDV) to prevent dengue in children aged 2-17 years. The data sources for this study were MEDLINE (from 1950 to December 2018), EMBASE (from 1947 to December 2018), and Cochrane (from 1993 to December 2018). The eligibility criteria of studies were randomized trials comparing efficacy, immunogenicity, and safety of CYD-TDV with placebo or other vaccines for preventing dengue cases in children aged 2-17 years.

In total, 9 studies involving 34,248 participants were included. The overall efficacy of CYD-TDV was found to be 60% [relative risk (RR): 0.40 (0.30 to 0.54)]. Serotype-specific efficacy of this vaccine was 51% for dengue virus type-1 (DENV-1) (RR: 0.49 (0.39 to 0.63)); 34% for DENV-2 (RR: 0.66 (0.50 to 0.86)); 75% for DENV-3 (RR: 0.25 (0.18 to 0.35)) and 77% for DENV-4 (RR: 0.23 (0.15 to 0.34)). Overall immunogenicity was 225.13 (190.34 to 259.93). Serotype-specific immunogenicity was: DENV-1: 176.59 (123.36 to 229.83); DENV-2: 294.21 (181.98 to 406.45); DENV-3: 258.78 (146.72 to 370.84) and DENV-4: 189.35 (141.11 to 237.59). The most common adverse events were headache and pain at the injection site. Based on the data mentioned above, it was concluded that CYD-TDV appears to bea safe option. It can partially protect children and adolescents against 4 serotypes of DENV for 1 year. Future research prioritizing improvements in vaccine efficacy, thus providing higher long-term protection against all virus serotypes is warranted.

Source: BMJ Open. 2019 Mar 13;9(3):e019368.