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Brazil's temporary suspension of the Butantan dengue vaccine after suspected serious adverse events should be interpreted neither as a failure of dengue vaccination nor as a definitive judgement on the product's safety.1 It is a timely reminder that pharmacovigilance is an active component of vaccine implementation, especially for live-attenuated flavivirus vaccines used in populations with heterogeneous baseline immunity, shifting serotype circulation, and previous exposure to related viruses. A safety signal is not causality.
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Nogueira et al. (2026) studied this question.
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