Background:Persistent vaccination inequities affect Indigenous and hard-to-reach populations in Latin America and the Caribbean (LAC), yet evidence on effective interventions remains fragmented. Objectives:To synthesize evidence on the effectiveness and feasibility of interventions designed to improve vaccination coverage among Indigenous and hard-to-reach populations in LAC. Design:Systematic review and meta-analysis following PRISMA 2020 guidelines. Methods:We searched PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, Google Scholar, and PAHO/WHO repositories for studies published between January 2015 and March 2025. Eligible studies reported primary data on vaccination coverage among Indigenous, rural, migrant, or marginalized populations in LAC. Two independent reviewers performed screening, data extraction, and quality assessment (JBI tools). Random-effects meta-analysis was conducted for comparable outcomes, with subgroup analyses by population and intervention type. Feasibility was assessed across logistical, financial, and cultural domains using an implementation science framework. Results:Of 2750 records, 21 studies met inclusion criteria, representing 10 LAC countries. Interventions included community health worker (CHW) outreach (43%), mobile units (29%), school-based delivery (14%), digital reminders (10%), and culturally tailored campaigns (5%). Meta-analysis of 16 studies showed that individuals receiving interventions were 64% more likely to achieve complete vaccination (risk ratio (RR) = 1.64; 95% confidence interval (CI), 1.32-2.04). Effects were stronger for Indigenous populations (RR = 1.85; 95% CI, 1.42-2.25) than for other rural groups (RR = 1.45; 95% CI, 1.20-1.80). CHW outreach and mobile units showed the largest effects. Feasibility was highest for CHW and culturally adapted strategies due to community trust, low costs, and adaptability. Conclusion:Community-based, culturally grounded interventions, particularly those integrating CHW networks and Indigenous leadership, significantly improve vaccination coverage among hard-to-reach populations in LAC. These findings support scaling equity-centered models within national immunization policies.
Cervical cancer remains a primary cause of gynecologic oncology-related mortality globally, with a disproportionate burden in sub-Saharan Africa. The pathogenesis of the disease is fundamentally driven by persistent infection with high-risk human papillomavirus (HPV) genotypes, most notably HPV-16 and HPV-18. The evolution of prophylactic HPV vaccination has transformed preventive oncology, progressing from first-generation bivalent and quadrivalent formulations to the nonavalent vaccine, which extended protection to five additional oncogenic types. These vaccines, composed of L1 virus-like particles (VLPs), induce robust and durable humoral and cellular immune responses, leading to population-level reductions of up to 98% in vaccine-type infections and 80% in high-grade cervical lesions. To address persistent global health disparities, regionally produced, cost-effective alternatives such as Cecolin and Cervavac have been introduced to enhance accessibility within low- and middle-income countries. This shift toward broader coverage is further supported by the 2022 WHO recommendation for a single-dose schedule, aimed at optimizing resource-limited immunization programs. Current research is now pivoting toward next-generation candidates targeting the conserved L2 protein for pan-genotype protection, as well as therapeutic vaccines targeting E6 and E7 oncoproteins to clear established infections. However, achieving the WHO’s 2030 cervical cancer elimination targets remains contingent upon overcoming infrastructural, cultural, and informational barriers that hinder vaccine uptake. This review synthesizes the molecular composition and immunological mechanisms of current and emerging HPV vaccines, evaluating their clinical efficacy and the systemic strategies required to ensure equitable global access.
Rabies remains a pressing public health issue, particularly in countries like India, where it inflicts a significant toll on marginalised communities. With approximately 20,000 deaths annually due to rabies, the disease underscores the urgency for effective prevention strategies. Despite the existence of post-exposure prophylaxis (PEP), rabies continues to claim lives, highlighting the importance of understanding and addressing the challenges in its implementation. This study aims to conduct a comprehensive analysis of strengths, weaknesses, opportunities and threats (SWOT) of India’s rabies PEP programme, emphasising the urgent need for enhanced strategies to combat this preventable yet incurable disease. A thorough review of scientific literature, governmental guidelines, programme documents and media reports related to rabies and PEP was undertaken. The SWOT matrix was employed to categorise the identified factors influencing PEP administration. The analysis revealed both strengths and weaknesses inherent in the current PEP programme. Despite the availability of effective biological products and political commitment, challenges such as inadequate inventory management, delayed dissemination of guidelines, poor awareness, inadequate infrastructure and budgetary constraints persist. However, opportunities for improvement, including information dissemination and technological innovations, were identified. Threats such as pandemics and misleading media reports pose additional challenges to rabies control efforts. By emphasising the preventable yet incurable nature of rabies and highlighting the annual toll it exacts on human lives, this study underscores the urgency for effective and coordinated public health interventions to achieve the goal of dog-mediated rabies elimination by 2030. The findings underscore the critical importance of addressing weaknesses and capitalising on opportunities to strengthen rabies control strategies in India. Proactive measures are essential to enhance inventory management, ensure guidelines’ dissemination, improve awareness levels, strengthen infrastructure and leverage technological advancements. Additionally, addressing threats such as pandemics and media misinformation requires collaborative efforts and proactive risk communication strategies. Through a targeted approach focused on enhancing rabies PEP implementation along with other measures such as community engagement to build awareness about rabies, and canine vaccination, including mass dog vaccination, India can significantly reduce the burden of rabies-related mortality.
Background:Lyme disease, the most common vector-borne illness in the Northern Hemisphere, is caused by Borrelia burgdorferi and transmitted via tick bites. With rising global incidence and no approved human vaccine, VLA15, a novel recombinant vaccine targeting six OspA serotypes, shows promise as an effective preventive strategy. Objective:This study aims to assess the safety and immunogenicity of the VLA15 vaccine among healthy or high-risk populations. Design:We conducted a systematic review and meta-analysis of three randomized controlled trials. Methods:This systematic review and meta-analysis, registered in PROSPERO (CRD420251058818), was conducted following PRISMA guidelines. A thorough search of PubMed, EMBASE, Cochrane Library, Scopus, ScienceDirect, and ClinicalTrials.gov was performed up to May 2025. Data extraction and quality assessment (using Cochrane ROB 2) were performed independently by reviewers. Risk ratios (RR) with 95% confidence intervals (CI) were calculated using random-effects models. Results:Three RCTs, including 5907 participants (4500 VLA15; 1407 placebo), met inclusion criteria. VLA15 recipients showed a significantly higher risk of adverse events: fever (RR 2.65, 95% CI: 1.77-3.96), headache (RR 1.40, 95% CI: 1.21-1.62), fatigue (RR 1.33, 95% CI: 1.15-1.55), and arthralgia (RR 2.50, 95% CI: 1.67-3.76), all with p < 0.0001. Subgroup analysis revealed a dose-response trend for arthralgia, particularly at 135 μg and 180 μg doses. However, nausea (RR = 1.34, p = 0.10) and severe unsolicited AEs (RR = 1.22, p = 0.42) were not statistically significant, suggesting no meaningful increase in these risks. Immunogenicity outcomes consistently favored VLA15, showing elevated IgG levels, GMTs, and seroconversion rates. Conclusion:VLA15 exhibits strong immunogenicity and acceptable safety, despite an increased risk of mild-to-moderate adverse events. Continued research and monitoring are warranted to support its use in Lyme disease prevention.
Global vaccine hesitancy, intensified by crises such as the COVID-19 pandemic, represents a significant threat to immunization coverage. This narrative review discusses immunization safety monitoring frameworks and vaccine hesitancy in crisis-affected regions, particularly in Lebanon, Ukraine, and Sudan. By examining and reflecting on these case studies, this review aims to examine challenges, highlight context-specific strategies, and propose solutions for enhancing vaccine uptake and trust in fragile and conflict-affected areas. A structured narrative review was conducted, collecting evidence from global frameworks and region-specific case studies. The review explored factors impacting vaccine hesitancy, the role of adverse events following immunization (AEFI) monitoring systems, and innovative technological interventions. Key sources included peer-reviewed articles, reports from humanitarian organizations, and systematic reviews. The review showed that vaccine hesitancy is affected by interconnected factors, including sociopolitical and cultural conflicts, and misinformation. Lebanon’s persistent economic and political instability, Ukraine’s disruptions caused by the ongoing war, and Sudan’s fragile healthcare infrastructure pose challenges to vaccine coverage. Successful interventions to address hesitancy included transparency in AEFI reporting, integration of real-time monitoring systems, and community-led initiatives. It is critical to mitigate vaccine hesitancy in crisis-affected regions through robust safety monitoring frameworks and tailored communication strategies. Global cooperation and frameworks, technological innovations, and context-specific approaches are imperative for improving the resilience of immunization systems and ensuring health security in fragile settings. Furthermore, these insights are crucial in informing public health communication policies and behavior change interventions to improve public trust and thus reduce vaccine hesitancy.
Background:The vaccination for human papillomavirus (HPV) is a widely acknowledged global measure aimed at preventing cervical cancer. However, the rate of vaccine adoption differs across various regions and countries due to a number of discouraging factors. Therefore, this study aimed to assess the uptake of HPV vaccination and associated factors among high school female students in Dessie City Administration, Northeast Ethiopia, 2023. Methods:School-based cross-sectional study was conducted among 410 high school female students in Dessie City Administration from April 1, 2023, to May 1, 2023. Participants were selected using a simple random sampling technique. The data were collected using self-administered questionnaires. Data were entered using EPI data version 4.6 and exported to SPSS version 26 for analysis. Data were presented with frequency tables, graphs, and pie charts. To determine the factors associated with the outcome, a two-step logistic regression approach was employed. Initially, a bivariable analysis identified potential predictor variables with a p-value of less than 0.25, which were then included in a multivariable model. A p-value of less than 0.05 and an adjusted odds ratio at a 95% confidence level were used to confirm associations. In addition, the Hosmer-Lemeshow test was used to assess the model's goodness of fit. Results:The overall uptake of the HPV vaccine among female high school students in Dessie City was 54.9% with 95% CI (50.2, 59.8). In this study finding, fathers' educational level (AOR = 5.00, 95% CI: (1.59, 15.73)), source of information (AOR = 2.08, 95% CI: (1.13, 3.83)), and having positive attitude toward HPV vaccination (AOR = 1.88, 95% CI: 1.23, 2.87) were variables that showed a significant association with uptake of HPV vaccine. Conclusion:In this study, nearly half a percent of female high school students did not uptake the HPV vaccine. Fathers' education level, source of information, and positive attitude were positively associated with the uptake of the HPV vaccine among female high school students. Therefore, schools should provide continuous school-based training about the HPV vaccine to foster attitudinal change among female high school students.
Vaccination in Africa faces significant challenges due to inadequate cold chain infrastructure, particularly in regions lacking reliable electricity. Approximately 80% of prequalified vaccines require cold chain systems to maintain their potency, which is often unfeasible in remote areas. Exposure to extreme temperatures can lead to a loss of vaccine potency, making it crucial to explore alternatives. Thermostable vaccines represent a technological advancement that addresses these challenges by eliminating the need for cold chain mechanisms during transport and storage. This narrative review analyzes trends in the uptake of thermostable vaccines and their impact across Africa. A total of 10 studies were reviewed, encompassing 14 African countries, revealing critical insights into the potential of thermostable vaccines to enhance immunization coverage in settings with limited access to traditional cold chain facilities. These vaccines, which maintain their efficacy even when exposed to higher temperatures for short periods, offer a promising solution to the logistical and economic hurdles of vaccine delivery in resource-limited settings.
Background:Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), is an ancient disease that continues to pose a significant threat to global public health. Although the BCG vaccine, developed in the 1920s, remains the only approved TB vaccine, it has limited efficacy, particularly against pulmonary TB in adults. The ID93/GLA-SE vaccine, a recombinant subunit vaccine, shows promise by triggering immune solid responses and could be a key solution in combating TB, particularly in the face of rising drug-resistant strains and suboptimal current vaccines. It has the potential to address the unmet need for more effective interventions against drug-resistant TB, a growing global health issue that continues to challenge existing treatment options. Objective:To evaluate the immunogenicity and safety of ID93 + GLA-SE in BCG-vaccinated healthy adults. Methods:A comprehensive electronic search on PubMed (Medline), ScienceDirect, EMBASE, Scopus, and Cochrane Central database was conducted from inception till August 2024 for randomized controlled trials (RCTs) with a target population of BCG-vaccinated healthy adults. This review was conducted according to (PRISMA) criteria and registered with PROSPERO (CRD42024601450). This meta-analysis used Review Manager and forest plots for visual display. The outcomes were displayed as risk ratios (RR) with a 95% confidence interval. Results:The ID93 + GLA-SE vaccine showed strong immunogenicity, particularly in high doses, with robust IgG responses sustained up to day 421 in all studies, significantly higher than baseline, and seroconversion rates remained high through day 84. CD4 T-cell responses peaked after the third dose and remained elevated through day 421, whereas CD8 T-cell responses were minimal. Regarding adverse effects, the ID93 + GLA-SE vaccine significantly increases fatigue (RR 3.24, p = 0.005), myalgia (RR 5.82, p < 0.0001), and injection site pain (RR 4.12, p < 0.00001), compared to placebo, with consistent results across both high and low doses. However, there were no significant differences for upper respiratory tract infections, 0.83 (95% CI 0.38-1.84, p = 0.87) or 1.77 (95% CI 0.77-4.10, p = 0.18) headaches. Dose optimization remains crucial due to the higher side effect risks of increased doses. Conclusion:The ID93 + GLA-SE vaccine shows a solid safety profile and enhances immune responses, especially IgG and CD4+ T-cell activity, which is crucial for TB defense. Higher doses improve efficacy but increase side effects, highlighting the need for dose optimization. As a potential alternative to the BCG vaccine, especially in drug-resistant TB regions, further research should refine dosage and assess long-term safety.
Background: Human papillomavirus (HPV) continues to pose a significant threat to public health, serving as the primary cause of cervical cancer. To address this issue, a vaccine has been developed to decrease the incidence of cervical cancer. However, the practice and its associated factors with the uptake of the vaccine have not been well studied in this particular region. Consequently, this study aims to evaluate the practice of HPV vaccination and its associated factors among female adolescent students in the Eastern Zone of Tigray, North Ethiopia, 2024. Methods: A cross-sectional study design was conducted from September 2023 to January 2024 at primary schools of the Eastern Zone, Tigray, Ethiopia. Data related to HPV vaccination practice and its associated factors were collected from 634 female adolescent primary school students. The collected data were checked for completeness daily, coded, entered, and cleaned using Epinfo version 7.2.3 then exported and analyzed using SPSS version 24. Bivariate and multivariate logistic regression analyses were used to assess the association between dependent and independent variables. The corresponding variables with a p -value ( p < 0.05) with a 95% confidence interval were considered statistically significant. Result: Among the 634 participants, 61.7% received the quadrivalent Gardasil HPV vaccine. Of these, 52.1% (330/634) demonstrated good knowledge, with an adjusted odds ratio (AOR) of 1.931 (95% confidence interval (CI), 1.364–2.735) and a p -value < 0.000. Moreover, participants who had a positive attitude toward HPV vaccination, with (AOR = 1.529, 95% CI = 1.049–2.230; p -value < 0.027) and participants who expressed their agreement for taking the HPV vaccine (AOR = 1.816, 95% CI = 1.046–3.152; p -value < 0.034) were factors associated with female adolescent students’ practice of the HPV vaccination. Conclusion and recommendation: The results indicated that the majority of study participants received one dose of the HPV vaccine. The study further reveals several factors associated with HPV vaccination among female adolescent students, including a positive attitude toward the vaccine and good knowledge about its benefits. Health authorities are recommended to promote the HPV vaccine through mass media in schools, religious institutions, and healthcare facilities to increase practice among adolescent females.
Background: Human papillomaviruses are the most common sexually transmitted infections, and persistent infection can lead to cervical cancer. In line with WHO recommendations to prevent cervical cancer, human papillomavirus vaccination is considered mandatory. Despite various challenges influencing decision-making for HPV vaccination, including HPV vaccine hesitancy, efforts are made to promote its uptake. Methods: A community-based cross-sectional study was conducted from March 1 to April 30 among 400 parents of adolescents. A simple random sampling technique was used to select study participants. A structured questionnaire was employed for data collection, and the data were gathered through interviews. Subsequently, the data were entered into EPI data 3.1 statistical software and analyzed using SPSS version 25. The association between variables was analyzed using bivariate and multivariable logistic regression models, and a p -value <0.05 at 95% confidence interval was considered statistically significant. Results: A total of 400 participants were included with a response rate of 99.3%. The prevalence of HPV vaccine hesitancy among parents of daughters was 54%. Multivariable logistic regression showed that educational status (Adjusted Odds Ratio (AOR) = 0.8, 95% CI: (0.69–0.93)), effectiveness of HPV vaccine (AOR = 1.9, 95% CI: (1.14–3.17)), knowledge (AOR = 0.5, 95% CI: (0.13–0.75)), and obtained information (AOR = 3.1, 95% CI: (2.24–4.29)) were significantly associated with human papillomavirus vaccine hesitancy. Conclusion: This study demonstrates that parents’ hesitance to vaccinate their daughters with the human papillomavirus vaccine was high. Parents’ hesitance to vaccinate their daughters with the human papillomavirus vaccine was strongly associated with the effectiveness of the HPV vaccine, obtained information about the HPV vaccine, knowledge, and educational status.
Background: Since the introduction of the SARS-CoV-2 vaccine, the incidence of complications associated with pediatric infection has markedly declined. However, there is a notable decline in vaccination coverage among younger age groups. The objective of this study was to identify the factors associated with hesitancy to receive the SARS-CoV-2 vaccine in parents of children aged 3–15 years in a Latin American context. Methods: A cross-sectional, analytical study was conducted between February and May 2023. Parents of children between the ages of 3 and 15, residing in the metropolitan region of Chile, were surveyed via an online or in-person questionnaire. Univariate analysis and a multivariate logistic regression model were performed. Results: Five hundred thirty-nine surveys were completed; 61.6% of parents were aged between 21 and 40 years, 42.3% had completed higher education, 79.4% had paid employment, and 98.1% were fully vaccinated. Age distribution of children was 36.9% for 3–5 years, 42.4% for 6–11 years, and 20.8% for 12–15 years. 87.4% was vaccinated. In the univariate analysis, vaccine hesitancy was observed in 9%, associated mainly with children 3–5 years, fewer doses in parents’ vaccination schedule, lacking risk perception and concerns about safety, and not knowing where to access pediatric vaccine formulations against COVID-19. In the multivariate analysis, the younger age, lacking risk perception, and concerns about the vaccine’s effectiveness were associated with vaccine hesitancy. Conclusion: Addressing hesitancy toward COVID-19 vaccines is of utmost importance. Educational interventions should be implemented to inform parents about the importance and effectiveness of COVID-19 vaccination in children, with special emphasis on parents of younger children, to increase vaccination coverage.
Vaccines against COVID-19 were viewed as a way out to the ongoing pandemic and were given the emergency use authorization in India to initiate mass vaccination in January 2021. This study aimed to investigate the serious adverse events following immunizations (AEFIs) reported for COVID-19 vaccines and to identify predictors of mortality among these cases from India. A secondary data analysis was conducted on the causality assessment reports for the 2708 serious AEFIs published by the National AEFI Committee under the Immunization Division, Ministry of Health and Family Welfare, Government of India. The analysis included all 21 reports published up until May 2023. The primary outcome variable analyzed was the survival/death status of each AEFI case, with various covariates from the published documents considered in the analysis. The majority of the serious AEFIs assessed were either coincidental (1220, 45%) or undetermined/unclassifiable (781, 28.8%). The majority of the serious AEFIs were reported among recipients of Covishield (1891, 69.8%) followed by Covaxin (347, 12.8%). Among these, 1114 (42.1%) died while the remaining 1594 (58.9%) were hospitalized and recovered. Systematically, AEFIs involving the cardiovascular system (696, 31.3%) were the most common, followed by those affecting the respiratory system (288, 13%) and neuropsychiatric system (295, 13.3%) which had a significant association with age (p < 0.001) and gender (p < 0.001). On multivariable analysis, females (p = 0.001), younger age groups (p < 0.001), AEFIs whose causality was determined and classified (p < 0.001), AEFI involving gastrointestinal and neuropsychiatric system (p < 0.001), AEFIs reported from North and Western India (p = 0.001) and those occurring during the winter season (p < 0.05) had significantly lower odds of mortality. Among the cohort of serious AEFIs reported, older age, male sex, undetermined or unclassifiable causality classification, and involvement of the cardiovascular system were associated with significantly higher odds of mortality and require close monitoring following vaccination.
Background: Respiratory syncytial virus (RSV) poses a significant respiratory health risk to senior citizens, contributing substantially to hospitalizations and mortality. With the recent approval of three RSV vaccines for the elderly, it is critical to understand the factors that can shape the RSV vaccination attitudes to inform public health strategies that can enhance uptake among this vulnerable population. Objectives: This study aimed to investigate the potential factors that could influence the attitudes toward RSV vaccination among senior citizens in Arab countries. Design: A multinational cross-sectional study, adhering to STROBE guidelines, was conducted using a survey instrument previously validated through exploratory factor analysis to assess attitudes toward the newly approved RSV vaccine. Methods: A self-administered online survey was distributed conveniently among senior citizens mainly across five Arab countries. The survey collected data on demographics, vaccination history, and key constructs related to RSV vaccine attitude, including “Fear,” “Information,” “Accessibility,” “Benefits,” and “Conspiracy.” Results: A total of 483 participants were included in the study, with the majority from five Arab countries: Jordan ( n = 239, 49.5%), Kuwait ( n = 74, 15.3%), Egypt ( n = 68, 14.1%), Saudi Arabia ( n = 51, 10.6%), and the UAE ( n = 23, 4.8%), alongside participants from other Arab nations ( n = 28, 5.8%). Among the respondents, 51.1% ( n = 247) expressed acceptance of the RSV vaccine, 22.4% ( n = 108) were hesitant, and 26.5% ( n = 128) exhibited refusal. Multivariate analysis identified perceived benefits (β = 0.484, p < 0.001), information needs (β = 0.229, p < 0.001), and previous vaccination history (β = 0.087, p = 0.016) as significant positive predictors of vaccine acceptance. Conversely, stronger conspiracy beliefs (β = −0.083, p = 0.035) were associated with vaccine resistance. Fear and accessibility were not significant predictors of vaccine attitudes. Conclusion: The findings showed that perceived benefits, access to reliable information, previous vaccination history, and conspiracy beliefs are essential to promote RSV vaccine acceptance among Arab seniors. These factors are recommended to improve RSV vaccine uptake in this vulnerable population.
Immune-related neuromuscular disorders are rare and potentially life-threatening adverse events of immune checkpoint inhibitors (ICIs) used in the treatment of cancer. They tend to have a chronic course that usually leads to the permanent discontinuation of immunotherapy. We present a case of pembrolizumab-induced myasthenia gravis that only involved the diaphragm. The patient is a 71-year-old female with a history of stage IV lung adenocarcinoma under maintenance therapy with pemetrexed and pembrolizumab after a complete response to first-line chemo-immunotherapy. She complained of orthopnea since the previous month and was admitted due to hypoxemic respiratory failure. Radiology showed decreased lung volumes and atelectatic areas in both lower lung fields. A subsequent bronchoscopy ruled out infection and cancer recurrence. Pulmonary function tests revealed a mixed disorder with a severe reduction in maximal inspiratory pressure and a large drop in vital capacity in the supine versus the sited position. Ultrasonography of the diaphragm confirmed bilateral diaphragmatic dysfunction, and the patient was initiated on non-invasive ventilation (NIV) during sleep, which led to symptom relief. A neurological physical examination did not reveal any other muscle involvement. Laboratory tests for myasthenic syndromes showed an elevated titer of the anti-acetylcholine receptor antibody, which confirmed the diagnosis of myasthenia gravis. The patient was subsequently treated with corticosteroids, pyridostigmine, and intravenous immunoglobulin and was gradually able to wean off supplemental oxygen. On follow-up, her chest X-ray and spirometry had improved, but she continued sleeping on NIV. Pembrolizumab was stopped, and she is still free of cancer after 9 months. Clinicians treating cancer patients with immunotherapy should be aware of this rare complication and perform timely investigations in any case of orthopnea in the course of ICI therapy to offer specialized management.
Dengue is a mosquito-borne flaviviral disease that is endemic to tropical and subtropical regions, affecting hundreds of millions of people worldwide. Although it was once considered a neglected disease, the incidence and mortality rates of dengue have surged over the past decade, in part due to the expanding distribution of the Aedes spp. vector facilitated by changing climatic factors. While most infections are asymptomatic or cause mild flu-like symptoms, some cases can develop into severe forms, leading to serious complications. The burden of the disease is gradually shifting from primarily affecting children, whose immune systems are immature, to increasingly impacting the older population, who typically experience waning immune responsiveness and comorbidities. With no specific treatment available, the development of a prophylactic vaccine is crucial for long-term control and prevention. School-age children are the primary target group for immunization programs of the two recently licensed dengue vaccines. However, there is limited information on the efficacy of either vaccine among the elderly or of two further immunogenic preparations currently undergoing clinical trials. This review gives an update on dengue vaccine implementation and provides recommendations for the vaccination of persons aged 60 years and above.
