The Story
“Dengue is raging in Brazil. A promising local vaccine is at least a year away”
https://www.science.org/content/article/dengue-raging-brazil-promising-local-vaccine-least-year-away
by Marcia Triunfol
Science, March 5, 2024
The Pitch
The spread of Dengue in Brazil over the past four decades has been an increasing challenge for public health authorities. Dengue fever, a disease caused by arboviruses transmitted primarily by the Aedes aegypti mosquito, has posed a substantial burden on urban populations in the country. The widespread prevalence of Dengue in Brazil is seen as a byproduct of the country’s inequality and socioeconomic disparities in which poor sanitation and housing conditions, combined with a deficient trash collection system, play a major role.
But this year, the incidence of Dengue fever in Brazil has reached unprecedented levels, prompting at least four states to declare a state of emergency, with more than 166,000 reported cases each. Currently, the coefficient of incidence is estimated at 120 cases per 1000 people. In the Federal District, where Brasília is located, there has been a staggering 1060% increase in Dengue incidence. This surge has led to the construction of a dedicated campaign hospital in Brasilia solely to manage Dengue cases.
Plans to vaccinate the population are among the top priorities set by the Federal Government to combat an even wider spread of the disease and reduce the likelihood of severe symptoms. To this end, the government is expected to acquire 6 million doses of the vaccine produced by Takeda Pharmaceutical, a Japanese manufacturer. This batch will be enough to vaccinate 3 million people only (1.5% of the population), as the immunization protocol requires two doses of the vaccine.
According to the Ministry of Health in Brazil, the incidence of Dengue in the country may reach 4.2 million cases in 2024. To be prepared for this dramatic scenario, the government is taking measures to have the single-dose, tetravalent Butantan–Dengue Vaccine (Butantan-DV) developed by the Butantan Institute in São Paulo, approved for distribution. Researchers at Butantan have just published the initial and encouraging results of an ongoing phase 3 clinical trial*, bringing a glimmer of hope amid the potential surge of millions of cases in the near future.
I’m very interested in this story. I would like to find out more about the strategy the government plans to implement for scaling up vaccine production to protect more than 200 million people, and the challenges associated with distribution logistics, as well as public acceptance of a new vaccine. Also, I want to report on this new vaccine efficacy and hear the opinions of experts in public health, epidemiology, and infectious diseases on the capacity of the Brazilian health care public system (known as SUS) to respond to this major outbreak.
Please let me know if you are interested in this story.
Thanks
Marcia
*Kallás, Esper G et al. “Live, Attenuated, Tetravalent Butantan-Dengue Vaccine in Children and Adults.” The New England Journal of Medicine. 390,5 (2024): 397-408. doi:10.1056/NEJMoa230179