{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:57:22Z","timestamp":1793948242257,"version":"4.8.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Nat Med"],"published-print":{"date-parts":[[2026,4]]},"DOI":"10.1038\/s41591-026-04255-3","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T10:02:07Z","timestamp":1772618527000},"page":"1393-1400","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Long-term efficacy and safety of the single-dose tetravalent Butantan dengue vaccine"],"prefix":"10.1038","volume":"32","author":[{"given":"Esper G.","family":"Kall\u00e1s","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 A.","family":"Moreira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth G.","family":"Pati\u00f1o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia Emilia","family":"Braga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana C. V.","family":"Ten\u00f3rio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Bassolli de Oliveira","family":"Alves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Infante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela Haydee Ramos","family":"Silveira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Luiz","family":"Miraglia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica A. T.","family":"Cintra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7761-5498","authenticated-orcid":false,"given":"Dhelio Batista","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allex Jardim","family":"da Fonseca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo Queiroz","family":"Gurgel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo Castelo-Branco","family":"Coelho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2756-0588","authenticated-orcid":false,"given":"Cor Jesus Fernandes","family":"Fontes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3826-9358","authenticated-orcid":false,"given":"Ernesto T. A.","family":"Marques","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1425-926X","authenticated-orcid":false,"given":"Gustavo Adolfo Sierra","family":"Romero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6944-3008","authenticated-orcid":false,"given":"Mauro Martins","family":"Teixeira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2208-0294","authenticated-orcid":false,"given":"Andr\u00e9 M.","family":"Siqueira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7241-6844","authenticated-orcid":false,"given":"Viviane Sampaio","family":"Boaventura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiano","family":"Ramos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erivaldo Elias","family":"J\u00fanior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Cassio de Moraes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7324-1591","authenticated-orcid":false,"given":"C\u00e1ssia Fernanda","family":"Estofolete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela Carvalho","family":"Freitas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia Luiza Simoes","family":"dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria do Carmo S. T.","family":"Timenetsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6707-482X","authenticated-orcid":false,"given":"Stephen S.","family":"Whitehead","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6652-2851","authenticated-orcid":false,"given":"Anna P.","family":"Durbin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6165-197X","authenticated-orcid":false,"given":"Alejandra","family":"Esteves-Jaramillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tulin","family":"Shekar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Jin","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuxu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julieta","family":"Macey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanskruti","family":"Vaidya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth-Ann G.","family":"Coller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9388-9210","authenticated-orcid":false,"given":"Fernanda Castro","family":"Boulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1102-2419","authenticated-orcid":false,"given":"Mauricio L.","family":"Nogueira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus V\u00ednicius Guimar\u00e3es de","family":"Lacerda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"4255_CR1","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1038\/nature12060","volume":"496","author":"S Bhatt","year":"2013","unstructured":"Bhatt, S. et al. The global distribution and burden of dengue. Nature 496, 504\u2013507 (2013).","journal-title":"Nature"},{"key":"4255_CR2","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1016\/S1473-3099(16)00026-8","volume":"16","author":"JD Stanaway","year":"2016","unstructured":"Stanaway, J. D. et al. The global burden of dengue: an analysis from the Global Burden of Disease Study 2013. Lancet Infect. Dis. 16, 712\u2013723 (2016).","journal-title":"Lancet Infect. Dis."},{"key":"4255_CR3","doi-asserted-by":"publisher","first-page":"taab146","DOI":"10.1093\/jtm\/taab146","volume":"28","author":"X Yang","year":"2021","unstructured":"Yang, X., Quam, M. B. M., Zhang, T. & Sang, S. Global burden for dengue and the evolving pattern in the past 30 years. J. Travel Med. 28, taab146 (2021).","journal-title":"J. Travel Med."},{"key":"4255_CR4","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1126\/science.239.4839.476","volume":"239","author":"SB Halstead","year":"1988","unstructured":"Halstead, S. B. Pathogenesis of dengue: challenges to molecular biology. Science 239, 476\u2013481 (1988).","journal-title":"Science"},{"key":"4255_CR5","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1126\/science.aan6836","volume":"358","author":"LC Katzelnick","year":"2017","unstructured":"Katzelnick, L. C. et al. Antibody-dependent enhancement of severe dengue disease in humans. Science 358, 929\u2013932 (2017).","journal-title":"Science"},{"key":"4255_CR6","doi-asserted-by":"publisher","first-page":"1358","DOI":"10.1016\/S0140-6736(14)61060-6","volume":"384","author":"MR Capeding","year":"2014","unstructured":"Capeding, M. R. et al. Clinical efficacy and safety of a novel tetravalent dengue vaccine in healthy children in Asia: a phase 3, randomised, observer-masked, placebo-controlled trial. Lancet 384, 1358\u20131365 (2014).","journal-title":"Lancet"},{"key":"4255_CR7","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1056\/NEJMoa1411037","volume":"372","author":"L Villar","year":"2015","unstructured":"Villar, L. et al. Efficacy of a tetravalent dengue vaccine in children in Latin America. N. Engl. J. Med. 372, 113\u2013123 (2015).","journal-title":"N. Engl. J. Med."},{"key":"4255_CR8","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1056\/NEJMoa1800820","volume":"379","author":"S Sridhar","year":"2018","unstructured":"Sridhar, S. et al. Effect of dengue serostatus on dengue vaccine safety and efficacy. N. Engl. J. Med. 379, 327\u2013340 (2018).","journal-title":"N. Engl. J. Med."},{"key":"4255_CR9","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1056\/NEJMoa1506223","volume":"373","author":"SR Hadinegoro","year":"2015","unstructured":"Hadinegoro, S. R. et al. Efficacy and long-term safety of a dengue vaccine in regions of endemic disease. N. Engl. J. Med. 373, 1195\u20131206 (2015).","journal-title":"N. Engl. J. Med."},{"key":"4255_CR10","doi-asserted-by":"crossref","unstructured":"World Health Organization Dengue vaccine: WHO position paper, September 2018\u2014recommendations. Vaccine 37, 4848\u20134849 (2019).","DOI":"10.1016\/j.vaccine.2018.09.063"},{"key":"4255_CR11","doi-asserted-by":"publisher","first-page":"2009","DOI":"10.1056\/NEJMoa1903869","volume":"381","author":"S Biswal","year":"2019","unstructured":"Biswal, S. et al. Efficacy of a tetravalent dengue vaccine in healthy children and adolescents. N. Engl. J. Med. 381, 2009\u20132019 (2019).","journal-title":"N. Engl. J. Med."},{"key":"4255_CR12","doi-asserted-by":"publisher","first-page":"e257","DOI":"10.1016\/S2214-109X(23)00522-3","volume":"12","author":"V Tricou","year":"2024","unstructured":"Tricou, V. et al. Long-term efficacy and safety of a tetravalent dengue vaccine (TAK-003): 4.5-year results from a phase 3, randomised, double-blind, placebo-controlled trial. Lancet Glob. Health 12, e257\u2013e270 (2024).","journal-title":"Lancet Glob. Health"},{"key":"4255_CR13","unstructured":"World Health Organization Meeting of the Strategic Advisory Group of Experts on Immunization, September 2023: conclusions and recommendations. Wkly Epidemiol. Rec. 98, 599\u2013620 (2023)."},{"key":"4255_CR14","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1089\/vim.2006.19.10","volume":"19","author":"JE Blaney Jr.","year":"2006","unstructured":"Blaney, J. E. Jr., Durbin, A. P., Murphy, B. R. & Whitehead, S. S. Development of a live attenuated dengue virus vaccine using reverse genetics. Viral Immunol. 19, 10\u201332 (2006).","journal-title":"Viral Immunol."},{"key":"4255_CR15","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1016\/S1473-3099(20)30023-2","volume":"20","author":"EG Kallas","year":"2020","unstructured":"Kallas, E. G. et al. Safety and immunogenicity of the tetravalent, live-attenuated dengue vaccine Butantan-DV in adults in Brazil: a two-step, double-blind, randomised placebo-controlled phase 2 trial. Lancet Infect. Dis. 20, 839\u2013850 (2020).","journal-title":"Lancet Infect. Dis."},{"key":"4255_CR16","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1056\/NEJMoa2301790","volume":"390","author":"EG Kallas","year":"2024","unstructured":"Kallas, E. G. et al. Live, attenuated, tetravalent Butantan-dengue vaccine in children and adults. N. Engl. J. Med. 390, 397\u2013408 (2024).","journal-title":"N. Engl. J. Med."},{"key":"4255_CR17","doi-asserted-by":"publisher","first-page":"1234","DOI":"10.1016\/S1473-3099(24)00376-1","volume":"24","author":"ML Nogueira","year":"2024","unstructured":"Nogueira, M. L. et al. Efficacy and safety of Butantan-DV in participants aged 2\u201359\u2009years through an extended follow-up: results from a double-blind, randomised, placebo-controlled, phase 3, multicentre trial in Brazil. Lancet Infect. Dis. 24, 1234\u20131244 (2024).","journal-title":"Lancet Infect. Dis."},{"key":"4255_CR18","unstructured":"Brasil. Minist\u00e9rio da Sa\u00fade, Secretaria de Vigil\u00e2ncia em Sa\u00fade. Dengue: diagn\u00f3stico e manejo cl\u00ednico: adulto e crian\u00e7a. Diretoria T\u00e9cnica de Gest\u00e3o 4th edn (in Portuguese) (2013)."},{"key":"4255_CR19","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1146\/annurev-virology-101416-041848","volume":"5","author":"DR Glasner","year":"2018","unstructured":"Glasner, D. R., Puerta-Guardo, H., Beatty, P. R. & Harris, E. The good, the bad, and the shocking: the multiple roles of dengue virus nonstructural protein 1 in protection and pathogenesis. Annu. Rev. Virol. 5, 227\u2013253 (2018).","journal-title":"Annu. Rev. Virol."},{"key":"4255_CR20","doi-asserted-by":"publisher","first-page":"3411","DOI":"10.1016\/j.vaccine.2018.02.062","volume":"36","author":"KS Vannice","year":"2018","unstructured":"Vannice, K. S. et al. Clinical development and regulatory points for consideration for second-generation live attenuated dengue vaccines. Vaccine 36, 3411\u20133417 (2018).","journal-title":"Vaccine"},{"key":"4255_CR21","unstructured":"Brasil, Minist\u00e9rio da Sa\u00fade, Secretaria de Vigil\u00e2ncia em Sa\u00fade. Monitoramento das arboviroses e balan\u00e7o de encerramento do Comit\u00ea de Opera\u00e7\u00f5es de Emerg\u00eancia (COE) Dengue e outras Arboviroses 2024. Boletim Epidemiol\u00f3gico 55, 11 (in Portugese) (2025)."},{"key":"4255_CR22","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-021-21384-0","volume":"12","author":"UK Nivarthi","year":"2021","unstructured":"Nivarthi, U. K. et al. A tetravalent live attenuated dengue virus vaccine stimulates balanced immunity to multiple serotypes in humans. Nat. Commun. 12, 1102 (2021).","journal-title":"Nat. Commun."},{"key":"4255_CR23","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2022.2046960","volume":"18","author":"KL Russell","year":"2022","unstructured":"Russell, K. L. et al. A phase I randomized, double-blind, placebo-controlled study to evaluate the safety, tolerability, and immunogenicity of a live-attenuated quadrivalent dengue vaccine in flavivirus-naive and flavivirus-experienced healthy adults. Hum. Vaccin. Immunother. 18, 2046960 (2022).","journal-title":"Hum. Vaccin. Immunother."},{"key":"4255_CR24","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0005584","volume":"11","author":"SS Whitehead","year":"2017","unstructured":"Whitehead, S. S. et al. In a randomized trial, the live attenuated tetravalent dengue vaccine TV003 is well-tolerated and highly immunogenic in subjects with flavivirus exposure prior to vaccination. PLoS Negl. Trop. Dis. 11, e0005584 (2017).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"4255_CR25","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1093\/infdis\/jiw067","volume":"214","author":"AP Durbin","year":"2016","unstructured":"Durbin, A. P. et al. A 12-month-interval dosing study in adults indicates that a single dose of the National Institute of Allergy and Infectious Diseases tetravalent dengue vaccine induces a robust neutralizing antibody response. J. Infect. Dis. 214, 832\u2013835 (2016).","journal-title":"J. Infect. Dis."},{"key":"4255_CR26","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1126\/science.aaf5036","volume":"352","author":"NR Faria","year":"2016","unstructured":"Faria, N. R. et al. Zika virus in the Americas: early epidemiological and genetic findings. Science 352, 345\u2013349 (2016).","journal-title":"Science"},{"key":"4255_CR27","doi-asserted-by":"publisher","first-page":"1885","DOI":"10.3201\/eid2110.150847","volume":"21","author":"GS Campos","year":"2015","unstructured":"Campos, G. S., Bandeira, A. C. & Sardi, S. I. Zika virus outbreak, Bahia, Brazil. Emerg. Infect. Dis. 21, 1885\u20131886 (2015).","journal-title":"Emerg. Infect. Dis."},{"key":"4255_CR28","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.adn2199","volume":"16","author":"JV Zambrana","year":"2024","unstructured":"Zambrana, J. V. et al. Primary exposure to Zika virus is linked with increased risk of symptomatic dengue virus infection with serotypes 2, 3, and 4, but not 1. Sci. Transl. Med. 16, eadn2199 (2024).","journal-title":"Sci. Transl. Med."},{"key":"4255_CR29","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0011710","volume":"17","author":"CF Estofolete","year":"2023","unstructured":"Estofolete, C. F. et al. Influence of previous Zika virus infection on acute dengue episode. PLoS Negl. Trop. Dis. 17, e0011710 (2023).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"4255_CR30","doi-asserted-by":"publisher","DOI":"10.1126\/science.adl3564","volume":"388","author":"K Nunes","year":"2025","unstructured":"Nunes, K. et al. Admixture\u2019s impact on Brazilian population evolution and health. Science 388, eadl3564 (2025).","journal-title":"Science"},{"key":"4255_CR31","doi-asserted-by":"publisher","first-page":"1430","DOI":"10.4269\/ajtmh.17-0948","volume":"99","author":"MC Whiteman","year":"2018","unstructured":"Whiteman, M. C. et al. Virus reduction neutralization test: a single-cell imaging high-throughput virus neutralization assay for dengue. Am. J. Trop. Med. Hyg. 99, 1430\u20131439 (2018).","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"4255_CR32","doi-asserted-by":"publisher","first-page":"4977","DOI":"10.1128\/JCM.43.10.4977-4983.2005","volume":"43","author":"BW Johnson","year":"2005","unstructured":"Johnson, B. W., Russell, B. J. & Lanciotti, R. S. Serotype-specific detection of dengue viruses in a fourplex real-time reverse transcriptase PCR assay. J. Clin. Microbiol. 43, 4977\u20134983 (2005).","journal-title":"J. Clin. Microbiol."},{"key":"4255_CR33","unstructured":"World Health Organization. Dengue Guidelines for Diagnosis, Treatment, Prevention and Control new edn. (World Health Organization, 2009)."},{"key":"4255_CR34","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1002\/sim.4780120708","volume":"12","author":"WC Blackwelder","year":"1993","unstructured":"Blackwelder, W. C. Sample size and power for prospective analysis of relative risk. Stat. Med. 12, 691\u2013698 (1993).","journal-title":"Stat. Med."},{"key":"4255_CR35","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-9-2","volume":"9","author":"J Beran","year":"2009","unstructured":"Beran, J. et al. Challenge of conducting a placebo-controlled randomized efficacy study for influenza vaccine in a season with low attack rate and a mismatched vaccine B strain: a concrete example. BMC Infect. Dis. 9, 2 (2009).","journal-title":"BMC Infect. Dis."},{"key":"4255_CR36","doi-asserted-by":"publisher","first-page":"2136","DOI":"10.1016\/S0140-6736(13)62630-6","volume":"383","author":"N Bhandari","year":"2014","unstructured":"Bhandari, N. et al. Efficacy of a monovalent human-bovine (116E) rotavirus vaccine in Indian infants: a randomised, double-blind, placebo-controlled trial. Lancet 383, 2136\u20132143 (2014).","journal-title":"Lancet"},{"key":"4255_CR37","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1214\/ss\/1009213286","volume":"16","author":"LD Brown","year":"2001","unstructured":"Brown, L. D., Cai, T. T. & DasGupta, A. Interval estimation for a binomial proportion. Stat. Sci. 16, 101\u2013117 (2001).","journal-title":"Stat. Sci."},{"key":"4255_CR38","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.1080\/03610929808832160","volume":"27","author":"ISF Chan","year":"1998","unstructured":"Chan, I. S. F. & Bohidar, N. R. Exact power and sample size for vaccine efficacy studies. Commun Stat.-Theor M. 27, 1305\u20131322 (1998).","journal-title":"Commun Stat.-Theor M."},{"key":"4255_CR39","doi-asserted-by":"publisher","first-page":"783","DOI":"10.2307\/3315916","volume":"28","author":"H Blaker","year":"2000","unstructured":"Blaker, H. Confidence curves and improved exact confidence intervals for discrete distributions. Can. J. Stat. 28, 783\u2013798 (2000).","journal-title":"Can. J. Stat."}],"container-title":["Nature Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04255-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04255-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04255-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T14:02:32Z","timestamp":1776780152000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04255-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,4]]},"references-count":39,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["4255"],"URL":"https:\/\/doi.org\/10.1038\/s41591-026-04255-3","relation":{},"ISSN":["1078-8956","1546-170X"],"issn-type":[{"value":"1078-8956","type":"print"},{"value":"1546-170X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,4]]},"assertion":[{"value":"12 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"E.G.K., J.A.M., E.G.P., P.E.B., J.C.V.T., L.B.O.A., V.I., D.H.R.S., J.L.M. and F.C.B. are employees of Instituto Butantan. M.A.T.C. was an employee of Instituto Butantan when the trial took place. E.G.K. is the current director of Instituto Butantan. F.C.B. reports owning stock from Novartis. Instituto Butantan, a nonprofit public health institution, provided research grants used by the site institutions to fund the clinical trial. S.S.W. reports that the vaccine technology was licensed by Butantan Foundation\/Institute from his employer (National Institutes of Health). A.P.D. is a consultant with Merck & Co., advising them on dengue vaccine development. A.E.-J., T.S., J.-J.L., D.C., S.V., J.M. and B.-A.G.C. are (or were) employees of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA and may own stock and\/or hold stock option in Merck & Co., Inc., Rahway, NJ, USA. D.B.P., A.J.d.F., R.Q.G., I.C.-B.C., C.J.F.F., E.T.A.M., G.A.S.R., M.M.T., A.M.S., V.S.B., F.R., E.E., J.C.M., C.F.E., A.C.F., C.L.S.d.S., M.C.S.T.T., M.L.N. and M.V.G.L. declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}