Dengue Vaccine Must Complement Prevention, Pg13

Key Highlights:

• The Central Drugs Standard Control Organisation (CDSCO) granted marketing authorization to Qdenga, India's first approved dengue vaccine, on July 21.
• Qdenga has been approved in 42 countries and has the WHO's imprimatur, with over 24 million doses administered worldwide.
• The vaccine provides protection against all four dengue virus types for those previously infected and against DENV-1 and DENV-2 for those not previously infected.
• Dengue is a fast-spreading mosquito-borne viral disease transmitted primarily by the Aedes aegypti mosquito.

Detailed Insights:

• The vaccine is administered in two doses, with flexibility for delayed second doses without restarting the schedule.
• Qdenga is not recommended for children under six due to lower efficacy and low prevalence of prior infection in that age group.
• The WHO advises against its use beyond 60 years until further safety and efficacy evidence is available.
• It is contraindicated for pregnant women, women planning pregnancy within one month, breastfeeding mothers, and immunocompromised individuals.
• The expected price of Rs 3,000-6,000 per dose suggests initial uptake will be primarily from the urban middle class.
• Inclusion in the Universal Immunisation Programme (UIP) requires robust epidemiological data to identify regions with significant dengue public health threats.
• WHO recommends considering routine immunization only in areas where dengue seroprevalence exceeds 60% by age nine or mean age of hospitalization is below 16 years.
• Vaccination is a complementary tool and should not replace comprehensive Integrated Vector Management (IVM) strategies.
• IVM includes eliminating mosquito breeding sites, biological measures like larvivorous fish, judicious chemical control, inter-agency coordination, and community participation.
• Aedes mosquitoes also transmit other diseases like chikungunya and Zika, underscoring the need for integrated vector control.

Key Concepts Involved:

• Dengue: A mosquito-borne viral disease caused by four closely related virus types (DENV-1, DENV-2, DENV-3, DENV-4).
• Qdenga: India's first approved dengue vaccine, developed to provide protection against dengue virus.
• Central Drugs Standard Control Organisation (CDSCO): The national regulatory body for Indian pharmaceuticals and medical devices.
• Universal Immunisation Programme (UIP): A large-scale public health program by the Government of India providing free vaccines against preventable diseases.
• Integrated Vector Management (IVM): A rational decision-making process for the optimal use of resources for vector control.
• Seroprevalence: The proportion of individuals in a population who have antibodies to an infectious agent, indicating prior infection or vaccination.