Development of Sanofi Pasteur tetravalent dengue vaccine

With almost 50% of the world population at risk and an estimated annual burden that includes 230M infections, 2M severe cases and 25000 deaths, dengue is a major public health concern. Brazil is a priority country for dengue vaccination as it accounts for 70% of all reported cases in Americas (1998-2009) and > 1 million clinical cases reported in 2010. After decades of research by different groups around the world, dengue vaccine development reached a major milestone in 2010 with the initiation of the first phase III clinical trial to investigate a candidate vaccine. This vaccine is the Sanofi Pasteur CYD tetravalent dengue vaccine (TDV) which is now being evaluated for protective efficacy in large scale trials in Latin America and south-east Asia as part of an extensive clinical development program in both regions. The CYD TDV candidate comprises four recombinant, live, attenuated vaccines (CYD-1–4) based on a yellow fever vaccine 17D (YF17D) backbone, each expressing the pre-membrane and envelope genes of one of the four dengue virus serotypes. The vaccine is genetically and phenotypically stable, non-hepatotropic, less neurovirulent than YF17D, and does not infect mosquitoes by the oral route.