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Oct 10, 2023 • 11:55 am CDT
AAP Pediatrics October 2023

Pertussis vaccination during pregnancy has been implemented in many high-resource countries, and recent data from the United States, the United Kingdom, and South America demonstrate its effectiveness in reducing infant pertussis in the first two months of life.

What has not been well established is whether 'blunting' (maternal immunological interference) has clinical consequences.

Blunting of the infant’s subsequent response to primary immunization by maternally derived antibodies has been demonstrated for many antigens.

A new study published in the journal Pediatrics disclosed pertussis vaccination near 28 weeks' gestation was associated with a lower risk of infection among infants through 8 months of age.

These Australian researchers reviewed records from 2013 through 2017 to calculate the impact after infants received diphtheria, tetanus, and pertussis DTaP doses.

The vaccine effectiveness (VE) from maternal vaccination in infants younger than two months was 70.4% (95% confidence interval 50.5% to 82.3%). 

Published on October 9, 2023, these researchers observed slightly lower VE point estimates for the third dose of infant pertussis vaccine among maternally vaccinated compared with unvaccinated infants (76.5% vs. 92.9%, P = .002) and did not observe higher rates of pertussis infection (hazard ratio, 0.70; 95% CI, 0.61–3.39).

The vaccine was given usually between 28 to 31 weeks gestation.

A commentary by Kathryn Edwards, MD, professor of pediatrics at Vanderbilt University Medical Center, stated, 'The consequences of maternally derived antibody on infant responses will need to continue to be monitored, as was done in the carefully conducted study of pertussis reported in this issue of Pediatrics. It will be critical to assess the burden of vaccine-preventable diseases and affirm that blunting from maternal immunization has no material impact on disease control.'

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Oct 9, 2023 • 9:57 am CDT
CDC Director video - World Polio Day October 2023

World Polio Day  is an opportunity to highlight efforts toward a polio-free world and honor the tireless contributions of those on the frontlines in the fight to eradicate polio from every corner of the globe.

The Global Polio Eradication Initiative (GPEI) confirmed World Polio Day is on October 24, 2023, and has launched a Make Polio History campaign to rally existing and new supporters of polio eradication..... through vaccination programs.

Over the past few years, the GPEI has led the deployment of the type 2 novel oral polio vaccine (nOPV2), which is genetically more stable than existing oral polio vaccines, with a lower risk of reversion to neurovirulence.

Approximately 750 million nOPV2 doses have been administered in more than 35 countries worldwide.

Unfortunately, polio outbreaks have been confirmed in various countries in 2023, led by Afghanistan and Pakistan.

The World Health Organization confirmed on August 25, 2023, that the spread of poliovirus remained a Public Health Emergency of International Concern and extended the emergency notice for an additional three months.

"It's Time to Make Polio History,' says U.S. CDC Director Mandy K. Cohen, MD, MPH, in a related video message posted on YouTube on October 4, 2023. "It won't be easy, but making history never is. We have the tools and knowledge to ensure no child is paralyzed by polio again."

In the United States, the IPV polio vaccine is offered at most health clinics and pharmacies.

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Oct 9, 2023 • 5:15 am CDT
from Pixabay

LimmaTech Biologics AG announced today the closing of a USD 37 million Series A financing round that will empower its proprietary technology platform and accelerate its preclinical and clinical vaccine candidates against increasingly dangerous bacterial infections, including programs addressing shigellosis and gonorrhea. 

Antimicrobial Resistance is responsible for approximately 5 million deaths annually. Infections that were once easily treatable have now become difficult, if not impossible, to cure.

As a leading example of this threat to global health, half of the approximately 700,000 annual gonorrhea infections in the U.S. are already resistant to antibiotics, and there is a real threat of gonorrhea soon becoming untreatable.

While there are no gonorrhea vaccines available, off-label vaccines and treatments are in use.

Later-stage clinical development efforts will focus on the company's Shigella vaccine program, which LimmaTech developed with GSK. The company expects to announce preliminary results from the Shigella program's ongoing Phase 2 clinical trial in the second half of 2023.

Shigella cause an estimated 450,000 infections in the U.S. each year.

According to the U.S. CDC, people can get a Shigella infection (shigellosis) after putting something in their mouth or swallowing something that has come into contact with the stool of someone with a Shigella infection.

"Within the next decade, multiple bacterial infections will become untreatable due to antimicrobial Resistance, which is already a significant burden on global health. By advancing our innovative technology platform, LimmaTech has the potential to simultaneously provide vaccine-induced protection against bacterial infections, mitigate the increasing risk of antibiotic resistance, and move toward the control of several highly transmissible pathogens," commented Dr. Franz-Werner Haas, CEO of LimmaTech, in a press release on October 9, 2023.

".....With this support and our team of proven experts in bacterial vaccine development and manufacturing, we look forward to providing life-changing vaccines to address a major global medical need."

The Company is conducting a Phase I/II clinical trial in the Republic of Kenya of a 4-valent candidate vaccine to help prevent diarrheal disease caused by the Shigella bacteria in children and infants in low and middle-income regions. The Shigella study is conducted in collaboration with GSK and the Wellcome Trust.

LimmaTech is committed to translating novel scientific concepts into highly effective vaccines that benefit humanity. For more information, please visit www.lmtbio.com.

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Oct 6, 2023 • 10:59 am CDT
Walgreens Flu Index Sept. 30, 2023

While the United States community is debating where and when the 2023-2024 flu season will arrive, the Walgreens Flu Index® ranks the top markets and states for flu activity, including Puerto Rico.

As of September 30, 2023, cities in the southern U.S. led the Top 10 Designated Market Areas with Flu Activity.

  1. Harlingen-Weslaco-Brownsville-McAllen, Texas
  2. Puerto Rico (San Juan)
  3. El Paso, Texas (Las Cruces, N.M.)
  4. Beaumont-Port Arthur, Texas
  5. New Orleans, La.
  6. Columbus-Tupelo-West Point-Houston, Miss.
  7. Honolulu, Hawaii
  8. Corpus Christi, Texas
  9. Houston, Texas
  10. Miami-Ft. Lauderdale, Fla.

From a more clinical perspective, the U.S. Centers for Disease Control and Prevention (CDC) today published its week #39 Influenza Surveillance Report.

As of October 6, 2023, seasonal flu rates last week were low nationally, with 444 (1%) positive specimens reported last week.

Additionally, 1,040 patients with laboratory-confirmed influenza were admitted to a hospital, an increased number since the previous CDC report.

And the U.S. National Center for Health Statistics mortality surveillance data distributed on October 5, 2023, confirmed that 11 additional influenza-related deaths were reported last week.

Of the flu-related deaths reported from October 2, 2022, to September 9, 2023, 9,697 (4%) listed influenza. 

This data exceeded the average number of influenza-coded deaths (8,530) from 2015-16 through 2019-20.

Among 5,390 hospitalized adults with information on underlying medical conditions, 96.8% had at least one reported underlying medical condition; the most commonly reported were hypertension, cardiovascular disease, metabolic disorder, and obesity. 

The CDC's new Director, Mandy K. Cohen, MD, MPH, recently answered questions and offered the most up-to-date information and common-sense solutions so you can protect yourself and your loved ones this respiratory season.

This week's updated flu shot availability news indicated that over 100 million influenza vaccines had been distributed to health clinics and pharmacies in the U.S.

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Oct 6, 2023 • 6:10 am CDT
by Elena We

Without preventative vaccines available for three well-known sexually transmitted diseases, the U.S. Centers for Disease Control and Prevention (CDC) recently took action by opening a docket to obtain comments on proposed guidelines for the use of doxycycline post-exposure prophylaxis (PEP) for prevention of bacterial sexually transmitted infections (STI).

Announced on October 2, 2023, the proposed guidelines for bacterial STI prevention include post-exposure prophylaxis with doxycycline (doxycycline PEP) because it has demonstrated benefit in reducing chlamydia, gonorrhea, and syphilis infections.

The incidence of STIs caused by Neisseria gonorrhoeae (causative agent of gonorrhea), Chlamydia trachomatis (causative agent of chlamydia), and Treponema pallidum (causative agent of syphilis) continues to increase in the U.S., says the CDC.

The proposed guidelines provide updated clinical guidance for healthcare providers to inform the use of doxycycline PEP for preventing bacterial STI infections.

Written comments must be received on or before November 16, 2023.

Doxycycline PEP, when offered, should be implemented in the context of a comprehensive sexual health approach, including risk reduction counseling, STI screening and treatment, recommended vaccination, and linkage to HIV pre-exposure prophylaxis (PrEP), HIV care, or other services, as appropriate.

The CDC has made available a pre-recorded informational presentation to provide information about the studies considered when developing the proposed guideline, explain the public comment process, and provide an overview of important monitoring for antibiotic use and antibiotic resistance that the agency will consider to address potential risks.

You may submit comments identified by Docket No. CDC–2023–0080 at Federal eRulemaking Portal: http://www.regulations.gov. Follow the instructions for submitting comments. Do not submit comments by email, as the CDC does not accept comments by email.

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Oct 5, 2023 • 4:50 pm CDT
US FDA Vaccines and Related Biological Products Advisory Committee October 5, 2023

An independent committee of vaccine experts unanimously endorsed removing one influenza virus strain from future influenza vaccines.

On October 5, 2023, the Vaccines and Related Biological Products Advisory Committee (VRBPAC) voted to eliminate the influenza B/Yamagata lineage viruses since it has not been detected for about three years.

The VRBPAC vote follows the World Health Organization's recent announcement that it endorsed eliminating the influenza B/Yamagata/16/88 lineage component from the 2024 Southern Hemisphere flu shot formulation.

Flu seasons in the Southern Hemisphere usually occur between April and September, while the Northern Hemisphere's is generally between October and May.

This change should not impact the effectiveness of flu shots.

A recent U.S. CDC report found the adjusted vaccine effectiveness against severe acute respiratory infection hospitalization associated with any influenza virus during the 2023 Southern Hemisphere flu season was 51.9% (95% Confidence Interval 39.2%–62.0%).

For the 2023-2024 flu season in the U.S., there should be ample supply of vaccines at health clinics and pharmacies. According to a report by the Global Healthy Living Foundation and IQVIA, about 60% of vaccinations during the 2022 flu season took place at pharmacies in the U.S.

Vaccine manufacturers have projected to supply as many as 156.2 million to 170 million doses of influenza vaccines for the 2023-2024 season.

As of September 23, 2023, the CDC says about 100 million doses had been distributed in the U.S. All influenza vaccines are quadrivalent for this flu season, such as FLUMIST® and FLUCELVAX®.

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Oct 5, 2023 • 1:56 pm CDT
PAHO malaria map 2023

The Arkansas Department of Health (ADH) today announced it identified a case of locally acquired malaria in a resident who resides in Saline County and has no international travel history. 

ADH stated in a press release on October 4, 2023, that this is the only known locally acquired case of malaria in Arkansas and the 11th in the United States in 2023

Earlier in 2023, the U.S. Centers for Disease Control and Prevention (CDC) confirmed seven locally acquired malaria infections in Florida, one in Texas, and one in Maryland.

On September 7, 2023, the Pan American Health Organization estimated that approximately 41 million people are living in areas where the risk of infection by malaria is considered moderate to high in 21 Latin American countries.

The CDC has issued various outbreak alerts for malaria-endemic countries, including Costa Rica

According to the CDC, malaria is a vaccine-preventable disease caused by four species of protozoan parasites of the genus  Plasmodium. These disease-carrying mosquitoes are found throughout the Americas.

There are two malaria vaccines in use in Africa in 2023. However, they are not available in the U.S.

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Oct 5, 2023 • 1:13 pm CDT
by Adina Voicu

While there is currently no cure for cat allergy, a prevalent, life-long condition, an innovative therapeutic vaccine for humans has begun clinical trials.

Angany Inc. today announced that it has received clearance from U.K.'s Medicines and Healthcare Products Regulatory Agency for the first clinical study to be conducted on its vaccine candidate ANG-101 to treat human allergy to cats.

ANG-101 is a therapeutic vaccine that provides a disruptive disease-modifying approach for treating cat allergy.

Derived from its proprietary eBioparticle-Potentiated Immunotherapy™ technology, ANG-101 active immunotherapeutic ingredient is a unique 140 nm enveloped bioparticle (eBioparticle™) that mimics a virus in shape and size with its surface covered with thousands of copies of cat major allergen Fel d 1.

This clinical study is a first-in-human, open-label, and single-site evaluation of the new vaccine's safety, allergenicity, and immunogenicity in adult patients allergic to cat dander.

This early-stage clinical trial will be conducted under the guidance of Professor Stephen Durham and Dr Guy Scadding, two leading clinical allergy experts from Imperial College London.

Professor Durham commented in a press release on October 5, 2023, "The potential treatment of cat allergy using an auto-adjuvanted vector builds upon its known ability to induce strong allergen-specific IgG antibody responses, as observed in animal models."

Unlike prophylactic vaccines, Angany’s therapeutic vaccines are a new generation of immunotherapy biologics used to treat established pathologies.

They are meant to restore or boost natural immune mechanisms and create sustainable immune protection and vigilance.

Human allergies to cats and dogs affect 10 to 20% of the world’s population, says the Asthma and Allergy Foundation of America.

When you have a pet allergy, you are not allergic to the pet’s hair, fur, or feathers but to the protein found in the pet’s dander, saliva, and urine.

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Oct 4, 2023 • 1:34 pm CDT
by Gerd Altmann

Two world-class pharmaceutical companies announced an agreement for a potential first-in-class vaccine against extraintestinal pathogenic E. coli.

On October 3, 2023, France-based Sanofi confirmed it has agreed with Janssen Pharmaceuticals, Inc., a Johnson & Johnson company, to develop and commercialize a 9-valent vaccine candidate for extraintestinal pathogenic E. coli currently in Phase 3 study.

The agreement combines Janssen's robust science behind this potential first-in-class product, Sanofi's worldwide manufacturing footprint, and the recognized world-class expertise of these companies in launching innovative vaccines.

This is important news since Extraintestinal pathogenic E. coli is a leading cause of sepsis, particularly in older adults, with an approved vaccine available in 2023.

Sepsis is a life-threatening bloodstream infection accompanied by severe illness and widespread organ damage generated by the body's self-destructive response to the infection.

Thomas Triomphe, Executive Vice President, Vaccines, at Sanofi, commented in a press release, "E. coli is a significant cause of sepsis, mortality, and antimicrobial resistance in older adults, and the number of cases is rising as the population ages."

"In line with our commitment to design and deliver first- or best-in-class medicines and vaccines, this agreement with Janssen aims to positively impact public health by reducing hospitalization costs and the burden on health systems associated with  ExPEC  and help older adults around the world to live longer healthier lives."

The ongoing Phase 3 E.mbrace clinical trial is designed to evaluate the efficacy of the 9-valent extraintestinal pathogenic  E. coli vaccine (ExPEC9V) compared to placebo in preventing invasive E. coli disease caused by ExPEC9V O-serotypes.

The study was started in 2021 by Janssen and continues to enroll patients. To learn more, visit  https://classic.clinicaltrials.gov/ct2/show/NCT04899336. 

Under the terms of the new agreement, both companies will co-fund current and future research and development costs.

Sanofi will pay USD 175M upfront to Janssen, followed by development and commercial milestones. A profit-share arrangement will exist in the U.S., EU4 (France, Germany, Italy, Spain), and the U.K. In the rest of the world, Janssen will receive tiered royalties and sales milestones.

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Oct 4, 2023 • 12:37 pm CDT
Florida Health Dept. RSV map September 30, 2023

Across both prepandemic and pandemic years, the respiratory syncytial virus (RSV) outbreaks in the United States began in Florida, the southeast, and later in the north and west regions. 

Florida's RSV season is longer than the rest of the U.S. and has distinct regional patterns, says the U.S. Centers for Disease Control and Prevention (CDC).

The Florida Department of Health reported as of week #39, September 30, 2023, RSV activity was increasing with higher test positivity, hospital admissions, and emergency room rates, with three previous outbreaks but no current RSV outbreak. 

Furthermore, NREVSS data show Florida's PCR positivity 3-week moving average was about 7.7% as of September 28, 2023.

Globally, the World Health Organization (WHO) Influenza Update N° 454 indicates RSV activity was found to be generally low, except in some parts of Western Australia and some Central and temperate South American countries.

Additional WHO and CDC RSV outbreak data are posted at Precision Vaccinations.

As of October 4, 2023, RSV vaccines and monoclonal antibody therapies are available in the U.S.

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Oct 3, 2023 • 4:14 pm CDT
by Gerd Altmann

For the first time, the U.S. government has authorized an updated protein-based COVID-19 vaccine.

Today, the U.S. Food and Drug Administration amended the emergency use authorization (EUA) of the Novavax COVID-19 Vaccine, Adjuvanted for use in individuals 12 years of age and older, to include the 2023-2024 formula.

Novavax Inc.'s updated vaccine addresses currently circulating variants to provide better protection against the serious consequences of COVID-19.

Consistent with the totality of the evidence and input from the FDA's expert advisors, the Novavax COVID-19 Vaccine, Adjuvanted, a monovalent vaccine, now includes the spike protein from the SARS-CoV-2 omicron coronavirus variant lineage XBB.1.5 (2023-2024 formula).

The FDA confirmed it has determined that the Novavax COVID-19 Vaccine, Adjuvanted (2023-2024 Formula), has met the statutory criteria for issuance of an EUA and that the known and potential benefits of the vaccine outweigh its known and potential risks in individuals 12 years of age and older. 

This means individuals 12 years of age and older previously vaccinated with a COVID-19 vaccine (and who have not already been vaccinated with a recently updated mRNA COVID-19 vaccine) are eligible to receive one dose, and unvaccinated individuals receive two doses.

Peter Marks, M.D., Ph.D., director of the FDA's Center for Biologics Evaluation and Research, commented in a press release on October 3, 2023, "Today's authorization provides an additional COVID-19 vaccine option that meets the FDA's standards for safety, effectiveness and manufacturing quality needed to support EUA."

From an availability perspective, Novavax previously indicated it had produced about 20 million doses of the updated vaccine and stored them in the U.S., enabling expedited delivery to health clinics and pharmacies.

As part of today's action, the Novavax COVID-19 Vaccine, Adjuvanted (Original monovalent), is no longer authorized for use in the U.S. Additionally, global information about the Novavax COVID-19 Vaccine varies by country and is searchable at NovavaxMedInfo.com.

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Oct 3, 2023 • 11:19 am CDT
US CDC dengue case map October 2023

With the World Health Organization's (WHO) recent recommendation of a second dengue vaccine, this increased access may help reduce dengue outbreaks globally. About 4 billion people live in areas with a risk of dengue. 

In the United States, the CDC confirmed that 44 U.S. jurisdictions had reported about 997 dengue cases as of September 27, 2023.

During the summer of 2023, dengue outbreaks have been reported by the U.S. CDC in Florida, New Jersey, New York, and Puerto Rica.

In Florida, the Department of Health issued a statewide mosquito-borne illness advisory in June 2023. 

As of September 30, 2023, 38 locally acquired dengue cases have been reported this year, primarily in Miami-Dade County. Additionally, 334 travel-associated dengue fever cases were reported, primarily in people arriving from Cuba and Brazil. 

Over one thousand miles to the north, New York has reported 74 dengue cases, and New Jersey has confirmed 35 this year.

In the Caribbean Sea, the U.S. territory of Puerto Rica has reported 442 cases.

Anyone who lives in or travels to dengue-endemic areas is at risk for infection. According to the CDC, the four dengue viruses are spread to people through the bite of an infected Aedes species mosquito.

The CDC has issued various Travel Health Advisories regarding dengue outbreaks in 2023. Before visiting the areas, the CDC suggests discussing dengue vaccination options with a healthcare provider.

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Oct 3, 2023 • 5:13 am CDT
by Nancy Jane

In a new study published by BMC Public Health, researchers investigated the effect of zoster vaccination on dementia risk in an extensive UK population-based data set.

On October 2, 2023, these researchers disclosed an inverse association between zoster vaccination and dementia outcome in a fully adjusted model (HR 0.78, 95% CI: 0.77–0.79).

For Alzheimer's disease, the effect size is smaller (HR 0.91, 95% CI: 0.89–0.92); however, this result is likely only significant because of the large sample size involved.

To investigate if the result seen was exclusive to HZ vaccination, we also explored the effect of influenza vaccine and dementia/Alzheimer's disease.

They found a slight decreased hazard risk with HR of 0.96 (95% CI: 0.94–0.97) for dementia and HR of 1.10 (95% CI: 1.07–1.12) for Alzheimer's disease.

It has been estimated that the number of people with dementia could increase from 57 million cases in 2019 to 152 (130.8–175.9) million cases worldwide in 2050.

These researchers wrote, 'Several population-based studies have suggested a link between herpes zoster infection or vaccine against shingles and dementia. However, other population-based studies did not show any association between zoster infection and dementia risk.'

Globally, there are several approved shingles (herpes zoster) vaccines.

In the United States, GlaxoSmithKline plc Shingrix® is generally available at health clinics and pharmacies and has been reported up to 90% effective against shingles infection in various clinical trials.

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Oct 2, 2023 • 1:47 pm CDT
US CDC malaria map

Malaria vaccines have been in development since the 1960s, with substantial progress in the last decade, says the World Health Organization (WHO). Today, the WHO announced it has recommended a second vaccine, R21/Matrix-M, for preventing malaria in children.

As of October 2023, the R21 vaccine is the second malaria vaccine recommended by WHO, following the Mosquirix™ (RTS,S/AS01) vaccine, which received a WHO recommendation in 2021.

Demand for malaria vaccines is unprecedented in 2023. However, the available supply of RTS,S is limited.

The addition of R21 to the WHO's recommended malaria vaccine list is expected to result in sufficient vaccine supply in various countries.

The following steps for R21/Matrix-M, include completing the ongoing WHO prequalification and enabling international vaccine procurement for a broader rollout in malaria outbreak countries.

The WHO's Director-General endorsed the recommendation following its regular biannual meeting on 25-29 September 2023.

"As a malaria researcher, I used to dream of the day we would have a safe and effective vaccine against malaria. Now we have two," commented Dr Tedros Adhanom Ghebreyesus, WHO Director-General, in a press release on October 2, 2023.

"Demand for the RTS,S vaccine far exceeds supply, so this second vaccine is a vital additional tool to protect more children faster and to bring us closer to our vision of a malaria-free future."

The R21 vaccine has been shown to reduce symptomatic malaria cases by 75% during the 12 months following a 3-dose series. A fourth dose given a year after the third maintained efficacy. 

This efficacy is similar to that demonstrated when RTS,S is given seasonally. 

The WHO says that at US $2 – US $4 per dose, the cost-effectiveness of the R21 vaccine would be comparable with other recommended malaria interventions and other childhood vaccines.

Malaria is a disease caused by four species of protozoan parasites of the genus Plasmodium and is transmitted to people by Anopheles mosquitoes. 

According to the WHO's recent World Malaria Report, the global number of malaria cases reached about 240 million, with over 600,000 related fatalities.

As of October 2023, neither malaria vaccine is available in the United States.

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Oct 2, 2023 • 12:30 pm CDT
US CDC dengue map September 27, 2023

Dengue outbreaks continue to pose significant public health burdens in endemic countries and, unfortunately, may continue to increase in incidence as disease-carrying mosquitoes expand geographically, according to the World Health Organization (WHO).

To reduce the severity of dengue outbreaks, the WHO today announced the live-attenuated quadrivalent dengue vaccine Qdenga® (TAK-003) developed by Takeda has been confirmed to demonstrate efficacy against all four serotypes of the dengue virus in baseline seropositive children (4-16 years) in endemic countries.

And against serotypes 1 and 2 in baseline seronegative children.

The WHO's Strategic Advisory Group of Experts on Immunization (SAGE) on Immunization recommended on October 2, 2023, that Qdenga be considered for introduction in settings with high dengue disease burden and high transmission intensity to maximize the public health impact and minimize any potential risk in seronegative persons.  

The SAGE now recommends introducing Qdenga to children aged 6 to 16.

The vaccine should be introduced within this age range about 1-2 years before the age-specific peak incidence of dengue-related hospitalizations.

Qdenga should be administered in a 2-dose schedule with a 3-month interval between doses.

The WHO will consider the SAGE recommendation and update its paper on dengue vaccines to include final guidance on using Qdenga in public vaccination programs.

"The global impact of dengue cannot be overlooked as the incidence continues to rise. This week, the WHO's SAGE provided important recommendations for the use of QDENGA in preventing dengue," commented Gary Dubin, M.D., president of the Global Vaccine Business Unit at Takeda, in a press release on October 3, 2023.

While approved for use in Brazil and various European countries, Qdenga is unavailable in the U.S.

On July 11, 2023, Takeda announced that the Company has voluntarily withdrawn Qdenga's U.S. Biologics License Application following discussions with the U.S. Food and Drug Administration on aspects of data collection.

However, the Dengvaxia® vaccine is both FDA and WHO-recommended where appropriate.

As of September 13, 2023, 44 U.S. jurisdictions had reported about 997 dengue cases this year. Throughout the summer of 2023, dengue outbreaks have been reported in southern Florida and Puerto Rica.

Note: This article was updated on October 3, 2023, to include the Company's press release.

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