Development of live-attenuated dengue vaccine

Increasing of dengue cases each year burdens the public health and economic problems worldwide. Dengue virus (DENV) is the causative agent of the disease. Vaccine against this virus is a goal to prevent and eliminate dengue disease. The surface proteins, prM and E on top of the dengue virion are the major targets for vaccine. Variation of DENV strains is the key factor to target the vaccine antigens. A number of live-attenuated DENV vaccine candidate have been entering into different clinical trials. The breakthrough was the successful of the world first dengue vaccine development named Dengvaxia. This vaccine showed the overall efficacy to all 4 DENV serotypes about 60%. Due to its moderate efficacy, the use of this vaccine is therefore to reduce the hospitalization from DENV infection. The vaccine use is recommended in the dengue endemic region including Thailand, where high circulation of 4 DENV serotypes is observed. Unfortunately, the limitation of this vaccine is imbalance protection against 4 DENV serotypes, with the lowest level of protection to DENV-2. History of DENV-primed in individuals is the useful information to convey the effective and safe use of this dengue vaccine.