A single dose of Dengvaxia is associated with transient reduction in dengue infection risk among dengue-naïve children
- 1Department of Microbiology and Immunology, University of North Carolina
- 2Institute of Child Health and Human Development, University of the Philippines Manila
Abstract
Dengvaxia ® induces antibody responses in dengue virus (DENV)-naïve children, but the durability of these responses and their impact on subsequent wild-type (WT) DENV infection remain unclear. Although previous studies have primarily evaluated vaccine efficacy against dengue disease, the impact of Dengvaxia ® on susceptibility to WT DENV infection and subsequent immune responses remains less well defined. We evaluated vaccine-induced immunity and susceptibility to WT DENV infection in a longitudinal cohort of 186 seronegative children, including 114 who received a single dose of Dengvaxia ® and 72 who remained unvaccinated, followed for 40 months. Samples collected at baseline and two follow-up time points (20 months [T1] and 40 months [T2]) were analyzed using yellow fever virus (YFV) non-structural protein 1 (NS1) antibody assays, which is expressed by Dengvaxia ® but not by WT DENV, enabling discrimination between vaccine-associated and WT infection-induced responses. At T1, 61% of vaccinated children were responders. Additional low-level YFV NS1 antibody responses were detected in some children originally classified as vaccine non-responders, suggesting that the predefined binary classification may not capture the full range of vaccine-associated antibody responses. Low-level YFV NS1 responses remained detectable through T2. During the first follow-up period (baseline-T1), vaccination was associated with a reduced risk of WT DENV infection (vaccine effectiveness [VE]=45%). During the second period (T1-T2), no difference in infection risk was detected between groups. Following breakthrough infection during the first follow-up period, vaccinated children developed antibody responses with greater magnitude and broader serotype breadth than unvaccinated children with primary infection, consistent with vaccine-associated immune priming following WT DENV infection. In contrast, during the second period (T1-T2), differences in antibody magnitude and breadth following infection were no longer detected between groups. Together, these findings suggest that a single dose of Dengvaxia ® in DENV-seronegative children was associated with a reduced risk of WT DENV infection and with differences in subsequent antibody responses during the first follow-up period, but these associations were no longer observed during the second period.
Related
- Pharyngeal Microenvironment Associated with Human Rhinovirus Infection in Children: Insights from Metatranscriptomic Sequencing
- Markers of environmental enteric dysfunction are associated with changes in pharmacokinetics of praziquantel in preschool age children with Schistosoma mansoni infection in Albertine region of Uganda
- Epigenetic misprogramming of progenitor cells links transient viral infection to chronic diseases across tissues
- Timing of reduction glossoplasty and clinical outcomes in children with Beckwith–Wiedemann syndrome
- Effect of rosuvastatin and ezetimibe therapy on LDL-cholesterol reduction and non-invasive arterial injury markers in children with heterozygous familial hypercholesterolemia: a prospective, open-label, randomized study
BibTeX
@article{fernandez2026single,
title = {{A single dose of Dengvaxia is associated with transient reduction in dengue infection risk among dengue-naïve children}},
author = {Maria Abad Fernandez and Jedas Veronica Daag and Lindsay D. Hein and Kristal An Agrupis and Maria Vinna Crisostomo and Michelle Ylade and Jacqueline Deen and Laura J. White and Lakshmanane Premkumar and Ana Lena Lopez and Aravinda M. de Silva},
journal = {Frontiers in Immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1959704},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1959704/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - A single dose of Dengvaxia is associated with transient reduction in dengue infection risk among dengue-naïve children
AU - Maria Abad Fernandez
AU - Jedas Veronica Daag
AU - Lindsay D. Hein
AU - Kristal An Agrupis
AU - Maria Vinna Crisostomo
AU - Michelle Ylade
AU - Jacqueline Deen
AU - Laura J. White
AU - Lakshmanane Premkumar
AU - Ana Lena Lopez
AU - Aravinda M. de Silva
PY - 2026
DA - 2026/10/14
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1959704
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1959704/full
AB - Dengvaxia ® induces antibody responses in dengue virus (DENV)-naïve children, but the durability of these responses and their impact on subsequent wild-type (WT) DENV infection remain unclear. Although previous studies have primarily evaluated vaccine efficacy against dengue disease, the impact of Dengvaxia ® on susceptibility to WT DENV infection and subsequent immune responses remains less well defined. We evaluated vaccine-induced immunity and susceptibility to WT DENV infection in a longitudinal cohort of 186 seronegative children, including 114 who received a single dose of Dengvaxia ® and 72 who remained unvaccinated, followed for 40 months. Samples collected at baseline and two follow-up time points (20 months [T1] and 40 months [T2]) were analyzed using yellow fever virus (YFV) non-structural protein 1 (NS1) antibody assays, which is expressed by Dengvaxia ® but not by WT DENV, enabling discrimination between vaccine-associated and WT infection-induced responses. At T1, 61% of vaccinated children were responders. Additional low-level YFV NS1 antibody responses were detected in some children originally classified as vaccine non-responders, suggesting that the predefined binary classification may not capture the full range of vaccine-associated antibody responses. Low-level YFV NS1 responses remained detectable through T2. During the first follow-up period (baseline-T1), vaccination was associated with a reduced risk of WT DENV infection (vaccine effectiveness [VE]=45%). During the second period (T1-T2), no difference in infection risk was detected between groups. Following breakthrough infection during the first follow-up period, vaccinated children developed antibody responses with greater magnitude and broader serotype breadth than unvaccinated children with primary infection, consistent with vaccine-associated immune priming following WT DENV infection. In contrast, during the second period (T1-T2), differences in antibody magnitude and breadth following infection were no longer detected between groups. Together, these findings suggest that a single dose of Dengvaxia ® in DENV-seronegative children was associated with a reduced risk of WT DENV infection and with differences in subsequent antibody responses during the first follow-up period, but these associations were no longer observed during the second period.
SN - 1664-3224
ER -