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Estimating the public health importance of the CYD-tetravalent dengue vaccine: Vaccine preventable disease incidence and numbers needed to vaccinate.
Vaccine. 2016 Apr 29; 34(20):2397-401.V

Abstract

BACKGROUND

To evaluate the potential public health impact of the live attenuated tetravalent Sanofi Pasteur dengue vaccine (CYD-TDV) we analyzed data from the reported clinical trials to calculate vaccine preventable disease incidence (VPDI) and number needed to vaccinate (NNV) based on the licensure indication for persons age 9 years and above.

METHODS

VPDI is defined as incidence in an unvaccinated population X vaccine efficacy (VE), and thus incorporates both VE and the underlying burden of disease. NNV was calculated as 100,000 divided by VPDI divided by 2-year length of study. We compared these values to data for three newer vaccines that are currently integrated into some national immunization programs in Asia and Latin America, namely pneumococcal conjugate, Haemophilus influenzae type b, and rotavirus vaccines.

RESULTS

In the Asian-Pacific trial, in the first 25 months after the first dose of the dengue vaccine, CYD-TDV prevented annually 2639 cases of virologically confirmed dengue for every 100,000 persons vaccinated, for an NNV of 18. In the Latin American trial, given the overall lower annual dengue incidence compared to Asia, VPDI was 1707, and NNV 28. For the Asian-Pacific and Latin American studies, the VPDIs for hospitalized virologically confirmed disease at the trials' end were 638 and 239 per 100,000 population per year, respectively, with NNVs of 75 and 201. VPDI for confirmed dengue hospitalization was higher than that for Hib vaccine against Hib meningitis or all cause severe pneumonia while lower than that for rotavirus vaccine against severe rotavirus gastroenteritis.

CONCLUSIONS

Our analysis found that the CYD-TDV dengue vaccine had favorable VPDI and NNV, also when compared to existing vaccines used in Latin America and Asia. VPDI and NNV varied by serotype distribution, extent of prior dengue exposure (baseline seroprevalence) and country. These findings will help policy-makers decide where and how to introduce this vaccine post-licensure.

Authors+Show Affiliations

Agence de Médecine Preventive, Ferney-Voltaire, France.Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Institute of Public Health, University of Heidelberg, Germany. Electronic address: anneliesws@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27055020

Citation

Gessner, Bradford D., and Annelies Wilder-Smith. "Estimating the Public Health Importance of the CYD-tetravalent Dengue Vaccine: Vaccine Preventable Disease Incidence and Numbers Needed to Vaccinate." Vaccine, vol. 34, no. 20, 2016, pp. 2397-401.
Gessner BD, Wilder-Smith A. Estimating the public health importance of the CYD-tetravalent dengue vaccine: Vaccine preventable disease incidence and numbers needed to vaccinate. Vaccine. 2016;34(20):2397-401.
Gessner, B. D., & Wilder-Smith, A. (2016). Estimating the public health importance of the CYD-tetravalent dengue vaccine: Vaccine preventable disease incidence and numbers needed to vaccinate. Vaccine, 34(20), 2397-401. https://doi.org/10.1016/j.vaccine.2016.03.017
Gessner BD, Wilder-Smith A. Estimating the Public Health Importance of the CYD-tetravalent Dengue Vaccine: Vaccine Preventable Disease Incidence and Numbers Needed to Vaccinate. Vaccine. 2016 Apr 29;34(20):2397-401. PubMed PMID: 27055020.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Estimating the public health importance of the CYD-tetravalent dengue vaccine: Vaccine preventable disease incidence and numbers needed to vaccinate. AU - Gessner,Bradford D, AU - Wilder-Smith,Annelies, Y1 - 2016/04/05/ PY - 2015/11/28/received PY - 2016/03/01/revised PY - 2016/03/09/accepted PY - 2016/4/8/entrez PY - 2016/4/8/pubmed PY - 2016/10/19/medline KW - CYD-TDV KW - Dengue KW - Dengue vaccine KW - Number needed to vaccinate KW - Vaccine effectiveness KW - Vaccine efficacy KW - Vaccine preventable disease incidence SP - 2397 EP - 401 JF - Vaccine JO - Vaccine VL - 34 IS - 20 N2 - BACKGROUND: To evaluate the potential public health impact of the live attenuated tetravalent Sanofi Pasteur dengue vaccine (CYD-TDV) we analyzed data from the reported clinical trials to calculate vaccine preventable disease incidence (VPDI) and number needed to vaccinate (NNV) based on the licensure indication for persons age 9 years and above. METHODS: VPDI is defined as incidence in an unvaccinated population X vaccine efficacy (VE), and thus incorporates both VE and the underlying burden of disease. NNV was calculated as 100,000 divided by VPDI divided by 2-year length of study. We compared these values to data for three newer vaccines that are currently integrated into some national immunization programs in Asia and Latin America, namely pneumococcal conjugate, Haemophilus influenzae type b, and rotavirus vaccines. RESULTS: In the Asian-Pacific trial, in the first 25 months after the first dose of the dengue vaccine, CYD-TDV prevented annually 2639 cases of virologically confirmed dengue for every 100,000 persons vaccinated, for an NNV of 18. In the Latin American trial, given the overall lower annual dengue incidence compared to Asia, VPDI was 1707, and NNV 28. For the Asian-Pacific and Latin American studies, the VPDIs for hospitalized virologically confirmed disease at the trials' end were 638 and 239 per 100,000 population per year, respectively, with NNVs of 75 and 201. VPDI for confirmed dengue hospitalization was higher than that for Hib vaccine against Hib meningitis or all cause severe pneumonia while lower than that for rotavirus vaccine against severe rotavirus gastroenteritis. CONCLUSIONS: Our analysis found that the CYD-TDV dengue vaccine had favorable VPDI and NNV, also when compared to existing vaccines used in Latin America and Asia. VPDI and NNV varied by serotype distribution, extent of prior dengue exposure (baseline seroprevalence) and country. These findings will help policy-makers decide where and how to introduce this vaccine post-licensure. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/27055020/Estimating_the_public_health_importance_of_the_CYD_tetravalent_dengue_vaccine:_Vaccine_preventable_disease_incidence_and_numbers_needed_to_vaccinate_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(16)00328-5 DB - PRIME DP - Unbound Medicine ER -