{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T07:36:22Z","timestamp":1792136182555,"version":"4.4.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT 2017229"],"award-info":[{"award-number":["GNT 2017229"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Dengue is an increasingly important cause of illness in travellers, and Qdenga (TAK-003) is the first dengue vaccine incorporated into guidance for travellers in multiple countries. However, clinicians and travellers may encounter differing recommendations across jurisdictions. This study compared guidance on the use of Qdenga in travellers across countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a comparative analysis of national guidance on Qdenga use for travellers across countries, using survey data and structured review of publicly available recommendations. Guidance was synthesized according to dengue immune status and mapped across recurring decision domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Survey responses were obtained from 18 advisory bodies across 17 countries between March and April 2026, including 12 non-endemic countries where Qdenga was licensed and guidance published. Guidance was generally more restrictive than regulatory authorization. While there was broad agreement in recommending vaccination for travellers with laboratory-confirmed prior dengue infection, recommendations for those without documented infection varied widely. All advisory bodies considered destination-specific dengue risk but differed in whether and how they used travel duration, repeated or cumulative exposure, traveller characteristics and host susceptibility factors to determine vaccine eligibility. Some recommendations restricted vaccination to travellers with prior dengue infection, whereas others extended eligibility to selected travellers without documented prior infection or recommended vaccination based on exposure risk, irrespective of serostatus. Approaches also differed in assessment of prior dengue infection and whether completion of the two-dose series before travel was required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Variation in Qdenga guidance reflects differences in how advisory bodies interpret shared evidence and manage uncertainty arising from data gaps and differences between trial populations and travellers. Additional data on vaccine effectiveness and clinical outcomes among seronegative travellers and older adults may help reduce uncertainty and support greater alignment of future recommendations. Regardless, transparency and shared clinical decision-making remain essential when discussing dengue vaccination with travellers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jtm\/taag065","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:35:30Z","timestamp":1784633730000},"source":"Crossref","is-referenced-by-count":1,"title":["Shared evidence, different recommendations: a comparative analysis of Qdenga (TAK-003) dengue vaccine guidance for travellers across countries"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5725-0102","authenticated-orcid":false,"given":"Sarah L","family":"McGuinness","sequence":"first","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University , 553 St Kilda Road, Melbourne, VIC, 3004 \u00a0","place":["Australia"]},{"name":"Department of Infectious Diseases, The Alfred and School of Translational Medicine, Monash University , 55 Commercial Road, Melbourne, VIC 3004 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipti","family":"Patel","sequence":"additional","affiliation":[{"name":"National Travel Health Network and Centre (NaTHNaC), University College London Hospitals , 250 Euston Road, London NW1 2PG ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena H","family":"Askling","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Karolinska Institutet , K2 Medicin, Solna 171 77 Stockholm ,","place":["Sweden"]},{"name":"Academic Specialist Centre, Stockholm Health Care Services , Solnav\u00e4gen 1E, 113 65 Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Rothe","sequence":"additional","affiliation":[{"name":"Institute of Infectious Diseases and Tropical Medicine, LMU University Hospital , 80802 Munich, Bavaria ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Schofield","sequence":"additional","affiliation":[{"name":"Department of National Defence , Government of Canada, 101 Colonel By Drive, Ottawa, ON K1A 0K2 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7917-1141","authenticated-orcid":false,"given":"Robert","family":"Steffen","sequence":"additional","affiliation":[{"name":"Epidemiology, Biostatistics and Prevention Institute, Department of Public and Global Health, WHO Collaborating Centre for Travelers\u2019 Health, University of Zurich , Hirschengraben 84, CH-8001, Zurich ,","place":["Switzerland"]},{"name":"Division of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health , University of Texas, 7000 Fannin, Houston, TX 77030 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3600-9782","authenticated-orcid":false,"given":"Leo G","family":"Visser","sequence":"additional","affiliation":[{"name":"Dutch Coordination Centre for Travellers Health Advice , 1018 WT Amsterdam ,","place":["The Netherlands"]},{"name":"Leiden University Centre for Infectious Diseases, Department of Infectious Diseases, Leiden University Medical Centre , 2333 Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin H","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mount Auburn Hospital , 330 Mount Auburn Street, Cambridge, MA 02138 ,","place":["USA"]},{"name":"Faculty of Medicine, Harvard Medical School , 25 Shattuck Street, Boston, MA 02115 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"2026092909395664700_ref1","first-page":"665","article-title":"Dengue: global situation, surveillance and progress-2024 update background and global context","volume":"52","author":"World Health Organization (WHO)","year":"2025","journal-title":"Wkly Epidemiol Rec"},{"key":"2026092909395664700_ref2","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1080\/14787210.2026.2662312","article-title":"Dengue in a warming world: changing epidemiology, vaccines, and therapeutic developments","volume":"24","author":"Norman","year":"2026","journal-title":"Expert Rev Anti-Infect Ther"},{"key":"2026092909395664700_ref3","doi-asserted-by":"publisher","first-page":"taae089","DOI":"10.1093\/jtm\/taae089","article-title":"Epidemiology of travel-associated dengue from 2007 to 2022: a GeoSentinel 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