Dengue pre-vaccination screening strategies workshop
January 20-22, 2020 - Les Pensières Center for Global Health, Veyrier-du-Lac (France)
The Partnership for Dengue Control (PDC) organized a workshop on pre-vaccination screening for the use of dengue vaccines with differential performance dependent on serostatus: vaccine clinical updates, rapid diagnostic tests and implementation strategies, at Les Pensières Center for Global Health, January 20-22, 2020. This workshop was developed with the Global Dengue & Aedes-Transmitted Diseases Consortium (GDAC) Advisory Committee as a continuation of the workshop held in January 2019.
Dengue is a major public health problem with more than 3.6 billion people at risk for dengue virus (DENV) infection and an estimated 390 million infections annually in over 120 tropical and sub-tropical countries. In the absence of truly effective and sustainable vector control measures, a dengue vaccine is urgently needed. The first dengue vaccine was licensed in 2015; the live attenuated recombinant tetravalent vaccine CYD-TDV (Dengvaxia). However, new evidence highlighted the serostatus-dependent vaccine performance of Dengvaxia; a retrospective analysis of clinical trial data, stratifying participants according to their dengue serostatus before the first vaccine dose, revealed an excess risk of severe dengue in seronegative vaccine recipients, while in seropositive vaccine recipients, the vaccine was efficacious and safe.
The WHO recommended a pre-vaccination screening as the preferred strategy as with such a strategy predominantly persons with evidence of a prior dengue infection would be selected to be offered vaccination (based on serological test, or documentation of laboratory confirmed dengue infection in the past. To support the strategy, WHO and many expert panels highlighted the urgent need for rapid diagnostic tests (RDTs) to determine serostatus. To date, no RDT has been licensed for the indication of prior dengue infection status. Pre-vaccination screening strategies will benefit from RDTs that can be performed at point of care (POC), provide rapid test results, are sensitive and specific, as well as inexpensive for use in a population wide program.
Objectives of the meeting
Updates on new clinical data for CYD-TDV
- Discuss updates on recent clinical study results
- Address the impact of such data in terms of WHO recommendation / guidelines and on field implementation
Screening for prior dengue infection: Rapid diagnostic tests (RDTs) development updates
- Discuss RDT Target Product Profile (TPP) development status: where are we and next steps
- Updates on RDT development for pre-vaccination screening
- Address qualified- RDTs access for countries
Discuss implementation strategies for pre-vaccination screening programs for dengue vaccines
- Discuss practical issues for programmatic roll-out and get regional experiences feed-back on CYD-TDV
- Address programmatic challenges encountered by countries and the needs required for a successful implementation
- Discuss communication strategies with regards to vaccine confidence, both for policy makers, the medical community and the lay public
- Discuss cost-effectiveness data and modeling implementation approaches
Discuss Public health strategy for outbreak response
World Dengue Day target and expectations
- Duane Gubler, Emerging Infectious Diseases Program, Duke-NUS Medical School, Singapore
- Annelies Wilder-Smith, Partnership for Dengue Control; Lee Kong Chian School of Medicine, Singapore; Institute of Public Health, University of Heidelberg; Department of Global Health and Epidemiology, University of Umea
- Eng-Eong Ooi, Emerging Infectious Diseases Program, Duke-NUS Medical School, Singapore
- Anna Durbin, The Anna Durbin Lab; Johns Hopkins University School of Medicine