WHO登革热疫苗基本立场解读

Interpretation of WHO's basic position on dengue vaccines

2024年5月世界卫生组织发布了关于登革热疫苗基本立场文件,重点关注了登革热疫苗(TAK-003)。文件中建议在登革热高强度传播地区将此疫苗纳入常规免疫计划,优先为6~16岁儿童接种疫苗,应在与登革热相关住院病例的高峰年龄发病前1~2年接种,采用2剂间隔至少3个月的疫苗接种方案。对于孕妇、哺乳期妇女、免疫功能低下者以及有症状的HIV感染者等特定人群,文件不推荐该疫苗接种。文件还指出,TAK-003疫苗在血清阳性人群中表现出良好的安全性和有效性,但该疫苗可能不会对血清阴性疫苗接种者中的登革病毒(dengue virus,DENV)3和DENV4提供保护,并且根据目前可用的数据,如果血清阴性的人接触DENV3和DENV4,则不能排除发生严重登革热的潜在风险。此外,文件提到,会根据传播强度和接种年龄的不同而有所变化,但具体的成本效益需要在不同强度的传播环境中进行评估。目前尚无关于加强针使用的数据,因此不推荐接种加强针。最后,文件指出TAK-003疫苗与黄热疫苗、甲肝疫苗可同时接种,与人乳头状瘤病毒(human papillomavirus,HPV)疫苗同时接种的研究正在进行,这为未来登革热疫苗的接种策略提供了更多可能性。

In May 2024,the World Health Organization(WHO)issued a position paper on the dengue vaccines,focusing on the newly licensed TAK-003 vaccine.WHO recommends that this vaccine be included in routine immunization schedules in areas of high-intensity dengue transmission,targeting children aged 6-16 years 1-2 years before the peak age of onset of dengue-related hospitalized cases,using a vaccination regimen with a two-dose interval of at least 3 months.Due to limited safety data,the vaccine is not recommended for specific populations such as pregnant women,lactating women,immunocompromised individuals,and symptomatic HIV-infected persons.The document also notes that the TAK-003 vaccine shows good safety and effectiveness in seropositive persons,but may not confer protection against DENV3 and DENV4 in seronegative vaccine recipients.The potential risk of severe dengue cannot be ruled out if seronegative persons are exposed to DENV3 and DENV4 based on currently available data.Additionally,the document mentions that the cost-effectiveness of the TAK-003 vaccine may vary with transmission intensity and age at vaccination,necessitating evaluation in different transmission settings.Currently,there is no data on the use of booster doses,therefore a booster dose is not recommended.Finally,the document notes that the TAK-003 vaccine can be given concurrently with yellow fever and hepatitis A vaccines,and that studies of concurrent vaccination with HPV vaccine are ongoing,which opens up more possibilities for future dengue vaccination strategies.