Dengvaxia (tetravalent live-attenuated chimeric vaccine; Sanofi Pasteur) is a tetravalent vaccine comprised of four monovalent, chimeric live-attenuated vaccines (LAVs). The vaccine is currently approved in 19 dengue-endemic markets, although to date pilot public sector vaccination campaigns have only been initiated in Brazil and the Philippines.
Although Dengvaxia has the potential to address a major unmet need as the first-to-market dengue fever vaccine, its initial uptake has been disappointingly slow due to protracted pricing and reimbursement negotiations and uncertainty regarding the optimal rollout strategy for the vaccine in emerging markets. Moreover, uptake is expected to be further hampered by safety concerns in seronegative patients, which have led national authorities in Brazil to restrict the vaccine’s use, and those in the Philippines to suspend its marketing authorization.
The author believes that Dengvaxia’s sales will only rise in 2018 if Sanofi manages to achieve a successful rollout of public sector vaccination programs, as well as if it continues the rollout of the vaccine in the private sector of an increasing number of dengue-endemic markets. Given the delays to the incorporation of Dengvaxia into the public sectors of lower- and middle-income markets, private sector sales will be critical in ensuring that Sanofi achieves a return on investment before the anticipated launch of additional vaccines from 2019. From this time, Dengvaxia faces the threat of obsolescence in the most lucrative markets from rival LAVs and alternative vaccine approaches, which have the potential to provide superior protection against serotype 2 infections and/or shorter dosing schedules.
Dengvaxia: Dengue vaccines
List of Figures
Figure 1: Dengvaxia vaccine design
Figure 2: Dengvaxia for dengue fever - SWOT analysis
List of Tables
Table 1: Dengvaxia drug profile
Table 2: Dengvaxia pivotal trial data in dengue fever
Table 3: Dengvaxia ongoing late-phase trials in dengue fever