SAN JOSE, Costa Rica -- On Thursday, the national ministry of health of Costa Rica approved Sanofi Pasteur's tetravalent dengue vaccine, Dengvaxia, to protect individuals 9 to 45 years of age living in endemic areas against all four serotypes of dengue.
This approval in Costa Rica is the fourth registration of the dengue vaccine in Latin America, and the fifth in the world. Sanofi Pasteur's dengue vaccine has already been approved in Mexico, Brazil, El Salvador and the Philippines.
"Dengue is a disease that is beginning to hit us hard as a result of increased mobility and urbanization in the country. Already in 2016, we have recorded 7,711 cases of dengue at week 22 which is more than a 500% increase in incidence compared to last year," said Jorge Martinez, pediatrician member of the Pediatrician Society of Costa Rica. "Approval of the dengue vaccine gives us access to critical prevention tool against dengue to curb further spread of this debilitating disease in our country."
In April 2016, the Strategic Advisory Group of Experts (SAGE) on immunization to the World Health Organization (WHO) recommended endemic countries to consider introduction of Dengvaxia as part of integrated disease prevention including vector control and community mobilization. The WHO has set the objectives of reducing mortality by dengue by 50% and morbidity by 25% by 2020 in the endemic countries.
"Dengue represents a growing and serious public health issue in many parts of the Americas with significant associated human and economic burden," according to Cesar Mascarenas, Global Director of Medical Affairs for the Dengue Project, Sanofi Pasteur. "Approval of the dengue vaccine in Costa Rica will give the country's healthcare providers access to the first clinical preventive tool against dengue, allowing them to better protect their patients against this threat."
Public vaccinations against dengue began in the Philippines in April, with the goal of initiating the vaccination of 1 million fourth-grade students in highly-endemic regions of the country this year. Introduction of dengue vaccine in private and public immunization clinics in Brazil, Mexico and other countries in Central America are planned also to follow in coming months.
The global burden of dengue
According to the WHO, dengue is currently the fastest-growing mosquito-transmitted disease in the world, causing around 400 million infections every year. Over the last 50 years, dengue has spread; initially present in a handful of countries, it is now endemic in 128, inhabited by around four billion people. Also, the incidence of this disease has increased 30 times in this same period.
Even though dengue affects people of all ages and lifestyles, the greatest number of dengue cases worldwide occurs in individuals nine years of age and older, who represent a highly mobile and social segment of the community capable of contributing significantly to spread of the disease.
Sanofi Pasteur's dengue vaccine
Besides Costa Rica, Sanofi Pasteur's dengue vaccine has also been registered in Brazil, Mexico, El Salvador and the Philippines to date. Both private and public vaccinations against dengue have been successfully introduced in the Philippines and are being planned in other approval countries. The regulatory review process for the vaccine is continuing in other countries where dengue is a public health priority.
Sanofi Pasteur's dengue vaccine is the culmination of over two decades of scientific innovation and collaboration, as well as 25 clinical studies in over 15 countries around the world. More than 40,000 volunteers participated in the dengue vaccine clinical study program (phase I, II and III), of whom 29,000 volunteers received the vaccine.
Pooled efficacy and integrated safety analyses from the 25- month Phase III efficacy studies and the ongoing long-term studies, respectively, were published in The New England Journal of Medicine on July 27, 2015, documenting the vaccine's consistent efficacy and longer-term safety profile in a study population 9-16 years of age.
In the pooled efficacy analysis in this age group, Sanofi Pasteur's dengue vaccine was shown to reduce dengue caused by all four serotypes in two-thirds of the participants. Furthermore, this pooled analysis showed that Dengvaxia prevented up to 93% of severe dengue cases and eight out of ten hospitalizations.
Sanofi Pasteur's dengue vaccine is the first and only vaccine licensed for the prevention of dengue in the world. The first vaccine doses have already been produced and shipped to countries in Asia and Latin America; the full-scale production capacity of the dedicated vaccine facility in France is 100 million vaccine doses annually.