Sanofi Q&A session

Sanofi Q&A session2021-07-17T08:33:23+08:00
What counts as sero +ve Dengue for the purpose of the vaccine? Ig M, Ig G, NS1, PCR +ve? Also is there any indication that one needs a booster later on (e.g. after 6 yrs)? If the patient has fever, and low platelets, and NS1 or Ig M was +ve, is this patient eligible for vaccination 6 mths later?2021-07-17T08:21:37+08:00

Dengue history must be based on a recorded laboratory confirmation of past acute infection, which could have been tested at the time of infection by a direct diagnostic method such as polymerase chain reaction (PCR) or NS1 antigen to detect (part of) the virus or using an indirect diagnostic method such as dengue-specific serology to detect anti-dengue antibodies by ELISA or an RDT (WHO WER, 2018).

A booster dose of Dengvaxia® is not recommended. although existing clinical data on a booster dose of Dengvaxia® did not show any deleterious impact in terms of the immune or safety profile, the absence of any meaningful impact on the humoral response did not support an additional benefit of a booster dose. Therefore we do not recommend a booster dose in seropositive patients at this time.

Can patient who undergo kidney transplant with prior dengue episode be able to take the dengue vaccine?2021-07-17T08:23:21+08:00

Dengvaxia must not be administered to individuals with congenital or acquired immune deficiency that impairs cell-mediated immunity, including immunosuppressive therapies such as chemotherapy or high doses of systemic corticosteroids generally given for 2 weeks or more.

Any particular side effects i have to look out for, regarding dengue vaccine?2021-07-17T08:29:39+08:00

In the indicated population, the most common side effects of the vaccine (any severity/grade) include headache, injection-site pain, malaise and myalgia. These side effects are usually mild to moderate and resolve within 2–3 days (Gailhardou et al., 2016).

If a patient had dengue fever after the first shot Dengvaxia in 2019, does she need to repeat the first dose? or just continue to 2nd dose?2021-07-17T08:41:07+08:00

This person doesn’t need to repeat the first dose and continue to receive the 2nd dose.

Thailand has had JE vaccination for many years. The presence of JE antibodies in JE endemic countries can also affect the efficacy of dengue vaccination. What is your view on this, given dengue vaccine efficacy data from JE endemic countries?2021-07-17T08:30:48+08:00

During the Active Phase of CYD14, efficacy by country was consistent with the overall estimate the VE against VCD. The point estimates of VE in Thailand was similar to those in Philippines and in Indonesia, where no public JE vaccination program is implemented. It is still unclear whether pre-exposure of other flaviviruses could affect the efficacy or immune responses of dengue vaccines.

With this vaccine, can we stop spread the DENV by mosquitoes bite?2021-07-17T08:31:09+08:00

CYD-TDV has demonstrated prevention against symptomatic infections, as well as asymptomatic infections. Consequently, it could contribute to reducing viral transmission and thus to indirect protection if the vaccine coverage rates are sufficient. However, since CYD-TDV is now indicated only for people with prior dengue infection, it would be difficult to achieve vaccine coverage rates in a population, at which the herd effect could be identified.

With climate change, are we seeing Aedes egyptii in temperate countries too?2021-07-17T08:31:36+08:00

Yes. Many epidemiological factors such as population growth, global climate change, increased urbanization, migration and international trade can increase the proliferation and expansion of mosquito vectors (Grange et al., 2014)

Since covid symptoms is kind of alike to dengue . How would one be able to deduce that it is dengue and not covid to prevent false negative results?2021-07-17T08:31:54+08:00

Symptoms of Covid and acute dengue can be similar. Timely laboratory diagnosis (such as PCR) is the key to differentiate these two infections.

Proper data storage in case of dengue epidemics peak will help us to decide who to vaccinate or who can not. Is it a way? Need your views dear presenters2021-07-17T08:41:02+08:00

Persons with laboratory-confirmed history of dengue in their medical records can be considered to receive Dengvaxia, without the need of serotesting. Therefore a well-established database of confirmed dengue cases could help to identify individuals with prior dengue exposure. Dengue vaccination should ideally be performed 1–6 months after acute infection.

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