{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:03:12Z","timestamp":1792000992633,"version":"4.4.0"},"reference-count":33,"publisher":"American Society for Clinical Investigation","issue":"8","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":36,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"NIAID","doi-asserted-by":"crossref","award":["P01 AI106695\/AI\/NIAID NIH HHS\/United States"],"award-info":[{"award-number":["P01 AI106695\/AI\/NIAID NIH HHS\/United States"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"crossref"}]},{"name":"The Philippines Department of Health","award":["NA"],"award-info":[{"award-number":["NA"]}]},{"name":"International Vaccine Institute, South Korea","award":["NA"],"award-info":[{"award-number":["NA"]}]},{"name":"Hanako Foundation","award":["NA"],"award-info":[{"award-number":["NA"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,22]]},"abstract":"<jats:p>Dengue virus (DENV) vaccines should be designed to induce balanced protective immunity to all 4 DENV serotypes to mitigate the risk of vaccine-enhanced dengue disease. The first tetravalent live DENV vaccine (Dengvaxia) tested in humans was efficacious in children who were partially immune to DENV at baseline. In DENV-naive children, the vaccine was not efficacious and placed some children at risk of more severe WT DENV breakthrough infections. To define dengue vaccine responses at the individual patient level and their relationship to mild and severe dengue infections, we prospectively studied a cohort of DENV-naive children who received 1 dose of Dengvaxia. The vaccine stimulated variable responses that neutralized 0, 1 (monotypic), or 2+ (multitypic) serotypes in individual children. Using a logistic regression model, we found that vaccinated children with neutralizing antibody (NAb) to 1 serotype only were at greater risk developing dengue compared with children who were not vaccinated (odds ratio 5.07). This risk was not observed in vaccinated children with no NAb or NAb to 2 or more serotypes. We propose that individuals with durable NAb to 1 serotype have an abundance of serotype cross-reactive, nonneutralizing antibodies implicated in the enhanced replication of heterologous serotypes.<\/jats:p>","DOI":"10.1172\/jci.insight.200741","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T16:01:50Z","timestamp":1773763310000},"source":"Crossref","is-referenced-by-count":1,"title":["Safety of a tetravalent live dengue virus vaccine in children responding to one serotype only"],"prefix":"10.1172","volume":"11","author":[{"given":"Laura J.","family":"White","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay D.","family":"Hein","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Abad Fernandez","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7998-0141","authenticated-orcid":true,"given":"Cameron","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Freeman","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruby","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmanane","family":"Premkumar","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristal An","family":"Agrupis","sequence":"additional","affiliation":[{"name":"Institute of Child Health and Human Development, University of the Philippines Manila, Manila, Philippines."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Vinna","family":"Crisostomo","sequence":"additional","affiliation":[{"name":"Institute of Child Health and Human Development, University of the Philippines Manila, Manila, Philippines."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jedas Veronica","family":"Daag","sequence":"additional","affiliation":[{"name":"Institute of Child Health and Human Development, University of the Philippines Manila, Manila, Philippines."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Ylade","sequence":"additional","affiliation":[{"name":"Institute of Child Health and Human Development, University of the Philippines Manila, Manila, Philippines."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Deen","sequence":"additional","affiliation":[{"name":"Institute of Child Health and Human Development, University of the Philippines Manila, Manila, Philippines."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Lena","family":"Lopez","sequence":"additional","affiliation":[{"name":"Institute of Child Health and Human Development, University of the Philippines Manila, Manila, Philippines."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Katzelnick","sequence":"additional","affiliation":[{"name":"Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aravinda M.","family":"de Silva","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"232","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)02576-X"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1038\/s41564-020-0714-0"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.AID-0022-2014"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1126\/science.aan6836"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.840104"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac690"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a030700"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1172\/JCI147066"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0009258"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.celrep.2022.110930"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1714250115"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1800820"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-025-03771-y"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00522-3"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines13050483"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.00440-18"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiw576"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2019.11.061"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30494-8"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2017.09.089"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1126\/science.365.6457.961"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2019.1658503"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2021.07.042"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(24)00099-9"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-44330-8"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1812055115"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0007142"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-024-53916-9"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01392-9"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30126-9"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30392-2"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1128\/mbio.00386-22"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanmic.2024.07.014"}],"container-title":["JCI Insight"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/insight.jci.org\/articles\/view\/200741\/files\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T19:14:30Z","timestamp":1778872470000},"score":1,"resource":{"primary":{"URL":"https:\/\/insight.jci.org\/articles\/view\/200741"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":33,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,2,26]]},"published-print":{"date-parts":[[2026,4,22]]}},"alternative-id":["10.1172\/jci.insight.200741"],"URL":"https:\/\/doi.org\/10.1172\/jci.insight.200741","relation":{},"ISSN":["2379-3708"],"issn-type":[{"value":"2379-3708","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]},"article-number":"e200741"}}