Indonesia: Dengue Vaccine Rollout Marred by Concerns

Facts

• Controversy over potential safety concerns has emerged ahead of a planned rollout of a vaccine aimed at preventing infection from dengue in Indonesia next year. The jab of a drug called Qdenga was developed by Tokyo-based Takeda, with hopes to reduce the 20K annual deaths from the mosquito-borne disease.
• The first vaccine for dengue fever was developed more than seven years ago but was only effective for people with previous infections. This development encouraged Takeda to accelerate its actions to manufacture an alternative.
• According to researchers at Oxford University, the rate of dengue infections has increased eightfold over the last 20 years to nearly 400M infections annually. Scientists are warning that climate change will send the number of infections soaring because more than half the world's population already lives in vulnerable areas.
• One month after Qdenga was approved in Indonesia, the drug was recommended for approval by the Committee for Medicinal Products for Human Use of the European Medicines Agency (EMA) for use in Europe and dengue-endemic countries. The approval was based on data from trials that included more than 28K adults and children.
• Takeda's largest Qdenga trial showed that the vaccine prevented 84% of hospitalizations and 61% of symptomatic dengue cases. The data determined that Qdenga was safe and well-tolerated, and also provided protection against all dengue variations.
• However, scientists are concerned that the jab of Qdenga may induce a rare but serious condition called "antibody-dependent enhancement" (ADE), where the vaccine can produce antibodies that make the infection worse. A Univ. of North Carolina virologist recently expressed deep concern over Indonesia's approval of the vaccine for this reason.

Sources: Nature, Bloomberg, and Fiercepharma.

Narratives

• Narrative A, as provided by Science. In 2019, a pediatrician and a medical researcher in the Philippines were indicted over the premature and failed rollout of the dengue vaccine, Dengvaxia. Post rollout, 130 children died, sparking concerns over ADE and outrage from the parents of more than 830K children who received the vaccine. Botched rollouts have consequences — even for combating a disease as dangerous as dengue — and Indonesia should proceed with caution.
• Narrative B, as provided by WE Forum. There may be a different path to take. Researchers in Indonesia have also discovered a new way to fight dengue by breeding a special mosquito species designed to carry bacteria to prevent viruses like dengue from reproducing inside the insect. Deploying the mosquitos has shown a reduction in dengue cases by as much as 77%. This ecosystem-based solution may greatly reduce the need for unproven vaccines in the future.