A brief history
Dengue is sometimes called break-bone fever because of the intense aches it can cause. Reported infections have increased markedly in recent decades as the disease and its mosquito vectors have spread to more places. Outbreaks affect towns and cities as well as rural areas.
How does it spread?
Dengue spreads mainly through bites from infected Aedes aegypti mosquitoes, which are active during the day. A mosquito can acquire the virus from an infected person and pass it on through later bites. Bite prevention remains important whether or not vaccination is appropriate.
Symptoms and possible complications
Symptoms can include fever, headache, pain behind the eyes, muscle and joint aches, nausea and a rash. Many people recover within one to two weeks. Severe abdominal pain, persistent vomiting, bleeding or rapid breathing need immediate medical attention, even if the fever has settled. A previous dengue infection can increase the risk of severe illness with a later infection.
Where it may be relevant
- Travellers to dengue-risk areas where vaccination is supported by current guidance
- People with documented previous dengue infection when required by the product recommendation
- Those with repeated or prolonged exposure after specialist assessment
Dose schedules
The clinician will select the appropriate licensed schedule after reviewing age, health, previous doses and departure date.
Two-dose course
Eligible travellers
Eligibility must be confirmed before the first dose.
Who may be eligible
- Only people meeting the current product, age and previous-infection criteria
- Travellers whose benefits clearly outweigh vaccine-related risks
Who may not be eligible
- Anyone with a confirmed severe allergic reaction to a previous dose or a vaccine ingredient
- People who are acutely unwell with a significant fever may need vaccination deferred
- Pregnancy, breastfeeding, immune suppression and current medicines must be reviewed individually
- People without the required evidence of previous dengue infection may not be suitable
- Live dengue vaccines are generally unsuitable during pregnancy or significant immune suppression
Potential side effects
- Pain, redness or swelling where the injection is given
- Headache, tiredness, muscle aches or a mild fever
- Feeling faint around the time of vaccination
Important risks and precautions
- A severe allergic reaction is very rare and requires urgent treatment
- Protection is not absolute, so relevant food, water, bite or exposure precautions remain important
- The exact product and schedule must be confirmed during a clinical assessment
- Inappropriate use according to previous dengue status may alter the risk of severe disease; eligibility must be established clinically
Clinical references