Dengue Vaccination: What Everyone Should Know

Key Facts

One type of dengue vaccine is available for use in areas with risk of dengue in the United States:

• Dengvaxia® dengue vaccine

Who Should Get a Dengue Vaccine?

CDC recommends dengue vaccination for children 9 through 16 years old, but only when they have been previously infected with dengue and living in areas where dengue is common.  This previous infection should be confirmed by laboratory testing.  This vaccine is different from other vaccines in that it is only recommended for people who have already been infected with dengue virus.  The reason is that children without previous dengue infection are at increased risk for severe dengue disease and hospitalization if they get dengue after they are vaccinated with Dengvaxia.  Therefore, healthcare providers should check for evidence of a laboratory-confirmed previous dengue infection before vaccination.

Where does Dengue Commonly Occur?

Dengue is common in the U.S. territories of American Samoa, Puerto Rico, and the U.S. Virgin Islands, and the freely associated states, including the Federated States of Micronesia, the Republic of Marshall Islands, and the Republic of Palau.

Children 9 Through 16 Years Old

• The dengue vaccine is approved for use in children 9 through 16 years of age of who have a previous history of laboratory-confirmed dengue infection.
• Only children with laboratory-confirmed evidence of previous dengue infection should be vaccinated.
• Children must also be living in areas where dengue occurs frequently or continuously, which include American Samoa, Puerto Rico, and the U.S. Virgin Islands, and the freely associated states of the Federated States of Micronesia, the Republic of Marshall Islands, and the Republic of Palau.

Special Populations

Pregnancy

Pregnant people were not specifically enrolled and studied in the vaccine trials. Although no significant differences in adverse pregnancy outcomes between vaccinated and unvaccinated people were found, the number of pregnant people enrolled was too small to determine the effect of Dengvaxia on pregnancy.

Vaccine providers should consider the risk of dengue virus infection when making a recommendation for vaccination for pregnant people. Pregnant people are at increased risk of dengue-related complications.

Lactation

No data are available to evaluate Dengvaxia and breastfeeding.

Vaccine providers should consider the developmental and health benefits of breastfeeding as well as the risk of dengue virus infection to the breastfeeding person and infant.

Who Should Not Get a Dengue Vaccine?

The vaccine should not be administered to

• Children under 9 years of age
  • Children under 9 years of age are less likely to have had a prior dengue infection. For this reason, if your child is under the age of 9, they are not eligible for dengue vaccination.
• People over 16 years of age
  • The dengue vaccine is not licensed for people over 16. There is not enough data to show how well the vaccine works in that population.
• Children who have not had a prior dengue infection.
• Children with weakened immune systems (immunocompromised)
• Children who have had a severe (life-threatening) allergic reaction to a previous dose of the vaccine.
• Children who have a severe (life-threatening) allergy to any ingredient in this vaccine.
• Travelers and non-residents of areas where dengue is common. The FDA has not approved dengue vaccine for use in travelers.

What Type of Dengue Vaccine Is Available?

One type of dengue vaccine is available in the United States. The Dengvaxia vaccine will be available starting in 2022 for use in children 9 through 16 years old with laboratory-confirmed evidence of a previous dengue virus infection and living in areas where dengue is common (occurs frequently or continuously). Dengue is common in the U.S. territories of American Samoa, Puerto Rico, and the U.S. Virgin Islands, and freely associated states, including the Federated States of Micronesia, the Republic of Marshall Islands, and the Republic of Palau.

Dengvaxia Vaccine

Dengvaxia: Vaccine providers give three doses administered subcutaneously and each dose given 6 months apart (at 0, 6, and 12 months) for full protection.

How Well Do These Vaccines Work?

Overall, Dengvaxia protects children from dengue illness, hospitalizations, and severe dengue 8 out of 10 times (80%) in children who had dengue before vaccination. The vaccine protects against all four dengue virus types: dengue 1, 2, 3, and 4.

The vaccine provides years of protection

• We are still learning about how long the vaccine protects children. To date, we know that the vaccine can provide protection against dengue for at least 6 years.
• Over time, we will learn more about how long vaccine protection lasts.

While the vaccine is highly effective, there is a low risk that some vaccinated people can still get infected with dengue. This is called vaccine breakthrough.

What Are the Possible Side Effects of the Dengue Vaccine?

For children who HAVE already had dengue

• The most common side effects include soreness, itchiness, or pain in the injection site, headaches, lack of energy, and general discomfort. These side effects are normal signs that the body is building protection, and the side effects should go away within a few days.
• People sometimes faint after medical procedures, including vaccination. Tell your provider if you feel dizzy or have vision changes or ringing in the ears.
• As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death.

Problems that Could Happen After Getting Any Vaccine

• People sometimes faint after medical procedures, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting, and injuries caused by a fall. Tell the provider if you or your child feel dizzy, have vision changes, or have ringing in the ears.
• As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death.

Where Can I Find This Vaccine?

Your child’s healthcare provider is usually the best person to discuss recommended vaccines for your child. These vaccines are part of the routine childhood immunization schedule. Vaccines for children and teens are available at:

• Community health clinics

If your healthcare provider does not have these vaccines for children, ask for a referral.

Vaccines may also be available at:

• Pharmacies
• Workplaces
• Community health clinics
• Health departments
• Other community locations, such as schools and religious centers

You can also contact the health department in your U.S. territory or freely associated state to learn more about where to get vaccines in your community.

When receiving any vaccine, ask the provider to record the vaccine in the state or local vaccine registry, if available. This helps providers at future visits know what vaccines you or your child have already received.

How Can I Get Help Paying for This Vaccine?

Most health insurance plans cover routine vaccinations. The Vaccines for Children (VFC) program also provides vaccines for children 18 years and younger who are uninsured, underinsured, Medicaid-eligible, American Indian, or Alaska Native.