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Review
. 2025 Jan 30;13(2):145.
doi: 10.3390/vaccines13020145.

Dengue Vaccination: A Practical Guide for Clinicians

Kay Choong See  1
Affiliations
Review

Dengue Vaccination: A Practical Guide for Clinicians

Kay Choong See. Vaccines (Basel). .

Abstract

Dengue is a growing global public health challenge, with rising incidence and case fatality rates fueled by urbanization and climate change. The substantial mortality, morbidity, and economic burden associated with the disease underscore the need for effective prevention strategies, including vector control, personal protective measures, and vaccination. This narrative review provides a practical guide for clinicians to ensure the appropriate administration of dengue vaccines to at-risk groups, such as individuals in endemic regions and travelers to these areas. Live-attenuated tetravalent dengue vaccines, including Dengvaxia®, Qdenga®, and Butantan-DV, have demonstrated efficacy in clinical trials but require careful use due to the risk of antibody-dependent enhancement (ADE). To mitigate this risk, guidelines recommend vaccination primarily for individuals with prior confirmed dengue infection, emphasizing the importance of accessible and affordable point-of-care rapid testing. Co-administration of dengue vaccines with other live-attenuated or inactivated vaccines has been shown to be safe and immunogenic, broadening their potential application. However, live-attenuated vaccines are contraindicated for immunocompromised individuals and pregnant women. Enhancing clinician awareness, expanding diagnostic capabilities, and prioritizing high-risk populations are critical steps to optimize vaccination strategies. Combined with robust prevention programs, these efforts are essential to reducing the global burden of dengue and mitigating its impact.

Keywords: Aedes; antibody-dependent enhancement; flavivirus; serogroup; travel medicine; vector borne diseases.

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Conflict of interest statement

The author declares honoraria from AstraZeneca, GSK, Moderna, Sanofi, and Pfizer.

Figures

Figure 2
Figure 2
Selected dengue vaccines in clinical use and development. These include vaccines using the following platforms: live-attenuated virus [41,45,48], inactivated virus [101,102], mRNA [97], nucleic acid (DNA) [103,104], recombinant protein subunit [105], synthetic peptide [86], and virus-like particle [95,96].
Figure 1
Figure 1
Immune response and antibody-dependent enhancement in dengue infection among individuals aged 12 months or older. For information on dengue infection in infants younger than 12 months, see text.
See this image and copyright information in PMC

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