Recommendations for dengue vaccine implementation in the elderly population.

Area of Science:

• * Epidemiology and Public Health
• * Infectious Diseases and Virology
• * Vaccinology and Immunology

Background:

• * Dengue fever, a mosquito-borne flaviviral illness, is prevalent in tropical/subtropical areas, with increasing incidence and mortality.
• * Climate change facilitates the spread of the Aedes vector, exacerbating dengue's global impact.
• * Disease burden is shifting towards older adults with comorbidities and waning immunity, necessitating tailored prevention strategies.

Purpose of the Study:

• * To review the current implementation status of dengue vaccines globally.
• * To assess the available data on dengue vaccine efficacy and safety in the elderly population.
• * To provide evidence-based recommendations for vaccinating individuals aged 60 and above against dengue.

Main Methods:

• * Comprehensive literature review of published studies on dengue epidemiology, vector dynamics, and vaccine development.
• * Analysis of clinical trial data and real-world implementation data for licensed and investigational dengue vaccines.
• * Synthesis of information regarding vaccine efficacy, safety, and immunogenicity in different age groups, with a focus on older adults.

Main Results:

• * Two dengue vaccines are licensed, with school-age children as the primary target for current immunization programs.
• * Limited data exists on the efficacy of licensed vaccines in individuals aged 60 years and above.
• * Further immunogenic vaccine candidates are in clinical trials, with ongoing evaluation for broader age group applicability.

Conclusions:

• * Dengue vaccine implementation requires strategic planning to address evolving disease epidemiology and protect vulnerable populations.
• * Further research is essential to establish the safety and effectiveness of dengue vaccines in the elderly.
• * Recommendations are provided for the vaccination of older adults to mitigate dengue's growing burden in this demographic.