{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:01:53Z","timestamp":1793944913641,"version":"4.8.0"},"reference-count":94,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    The alarming growth of dengue worldwide, as well as its social and economic impact, has necessitated effective responses for its control. Brazil, the second country to use Dengvaxia\n                    <jats:sup>\u00ae<\/jats:sup>\n                    (Sanofi Pasteur, Paris, France) after the Philippines, has offered the vaccine to \u223c500,000 residents in 30 municipalities, with \u223c300,000 being vaccinated. In this population-based cohort study, the vaccine\u2019s effectiveness (VE) is reported after a 6-year follow-up for a vaccination campaign. The primary outcome was probable dengue case (PDC). Laboratory-confirmed dengue, serotype, warning signs, and hospitalization were considered secondary endpoints. Approximately 60% of participants received at least one vaccine dose. A total of 50,658 PDCs were identified, of which 15,131 were laboratory-confirmed dengue cases. Overall, the VE was 34% (95% CI: 33% to 35%) for PDCs and 20% (95% CI: 17% to 23%) for laboratory-confirmed cases. Greater VE was observed in older individuals. Vaccination was effective in reducing dengue virus (DENV)-1 and DENV-4 cases but not DENV-2 cases. No DENV-3 cases were registered. Among the 1,129 hospitalizations, 619 (54.8%) occurred within the vaccinated population, including 16 severe cases, whereas 510 (45.2%) hospitalizations occurred within the non-vaccinated population, with 18 severe cases. The VE for PDC hospitalizations was 16.5% (95% CI: 5.5% to 26.3%). Five and nine dengue-related deaths occurred within the vaccinated and non-vaccinated populations, respectively. The low incidence of severe cases and warning signs compromised accuracy. Vaccination with at least one dose was associated with approximately a one-third reduction in PDC incidence and a significant reduction in DENV-1 and DENV-4 cases. Despite the VE falling below 50%, vaccination may be justifiable in regions with high disease burden.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.24-0837","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T18:57:22Z","timestamp":1764874642000},"page":"338-347","source":"Crossref","is-referenced-by-count":2,"title":["Dengue Vaccine Effectiveness: Results from a 6-Year Population-Based Cohort Study in Southern Brazil"],"prefix":"10.4269","volume":"114","author":[{"given":"Karin Regina","family":"Luhm","sequence":"first","affiliation":[{"name":"Department of Public Health, Federal University of Paran\u00e1, Curitiba, Brazil;"},{"name":"Postgraduate Program in Public Health, Federal University of Paran\u00e1, Curitiba, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia Emiko","family":"Shimakura","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Public Health, Federal University of Paran\u00e1, Curitiba, Brazil;"},{"name":"Department of Statistics, Federal University of Paran\u00e1, Curitiba, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia Mara","family":"Raboni","sequence":"additional","affiliation":[{"name":"Department of Public Health, Federal University of Paran\u00e1, Curitiba, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magda Clara Vieira da","family":"Costa-Ribeiro","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Public Health, Federal University of Paran\u00e1, Curitiba, Brazil;"},{"name":"Department of Basic Pathology and Postgraduate Program in Microbiology, Parasitology and Pathology, Federal University of Paran\u00e1, Curitiba, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredi Alexander","family":"Diaz-Quijano","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Laboratory of Causal Inference in Epidemiology \u2013 LINCE-USP, School of Public Health, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Maron de Mello","sequence":"additional","affiliation":[{"name":"Health Ministry, Curitiba, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lineu","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Public Health, Federal University of Paran\u00e1, Curitiba, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilene da Cruz Magalh\u00e3es","family":"Buffon","sequence":"additional","affiliation":[{"name":"Department of Public Health, Federal University of Paran\u00e1, Curitiba, Brazil;"},{"name":"Postgraduate Program in Public Health, Federal University of Paran\u00e1, Curitiba, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliane Mara Cesario Pereira","family":"Maluf","sequence":"additional","affiliation":[{"name":"Department of Public Health, Federal University of Paran\u00e1, Curitiba, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Graeff","sequence":"additional","affiliation":[{"name":"Faculdade UNISE, Campo Largo, Paran\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Preto","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Public Health, Federal University of Paran\u00e1, Curitiba, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Almeida","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Public Health, Federal University of Paran\u00e1, Curitiba, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela Amanda de","family":"Sousa","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Public Health, Federal University of Paran\u00e1, Curitiba, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias Teixeira","family":"Krainski","sequence":"additional","affiliation":[{"name":"Department of Statistics, Federal University of Paran\u00e1, Curitiba, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan Arnold","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Basic Pathology and Postgraduate Program in Microbiology, Parasitology and Pathology, Federal University of Paran\u00e1, Curitiba, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise Siqueira de","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Department of Public Health, Federal University of Paran\u00e1, Curitiba, Brazil;"},{"name":"Postgraduate Program in Public Health, Federal University of Paran\u00e1, Curitiba, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","article-title":"Vector-Borne Diseases.","year":"2024"},{"key":"b2","series-title":"EClinicalMedicine","first-page":"100712","article-title":"Global, regional, and national dengue burden from 1990 to 2017: A systematic analysis based on the global burden of disease study 2017","volume":"32","author":"Zeng","year":"2021"},{"key":"b3","series-title":"J Travel Med","first-page":"taae089","article-title":"Epidemiology of travel-associated dengue from 2007 to 2022: A GeoSentinel analysis","volume":"31","author":"Duvignaud","year":"2024"},{"key":"b4","article-title":"Epidemiological Update for Dengue, Chikungunya and Zika in 2022.","year":"2022"},{"key":"b5","series-title":"Boletim Epidemiol\u00f3gico","first-page":"1","article-title":"Monitoramento dos casos de arboviroses urbanas transmitidas pelo Aedes.","volume":"54","year":"2023"},{"key":"b6","series-title":"PLoS Negl Trop Dis","first-page":"e0006227","article-title":"The impact of insecticide applications on the dynamics of resistance: The case of four Aedes 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(not) in the room","volume":"2","author":"Olliaro","year":"2021"},{"key":"b22","series-title":"N Engl J Med","first-page":"327","article-title":"Effect of dengue serostatus on dengue vaccine safety and efficacy","volume":"379","author":"Sridhar","year":"2018"},{"key":"b23","series-title":"Int J Environ Res Public Health","first-page":"2062","article-title":"Dengue surveillance system in Brazil: A qualitative study in the Federal District","volume":"17","author":"Angelo","year":"2020"},{"key":"b24","series-title":"PLoS One","first-page":"e0199180","article-title":"Bias due to differential and non-differential disease and exposure misclassification in studies of vaccine effectiveness","volume":"13","author":"De Smedt","year":"2018"},{"key":"b25","series-title":"Cold Spring Harb Perspect Biol","first-page":"a029520","article-title":"Which dengue vaccine approach is the most promising, and should we be concerned about enhanced disease after vaccination? 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The path to a dengue vaccine: Learning from human natural dengue infection studies and vaccine trials","volume":"10","author":"de Silva","year":"2018"},{"key":"b43","series-title":"Int J Epidem","first-page":"226","article-title":"Collider scope: When selection bias can substantially influence observed associations","volume":"47","author":"Munafo","year":"2018"},{"key":"b44","article-title":"Comunicado Sobre a Descontinua\u00e7\u00e3o Definitiva da Fabrica\u00e7\u00e3o\/Importa\u00e7\u00e3o do Medicamento DENGVAXIA\u00ae (Vacina Dengue 1, 2, 3 e 4, Recombinante e Atenuada).","year":"2025"},{"key":"b45","series-title":"npj Vaccines","first-page":"192","article-title":"Long term T cell response and safety of a tetravalent dengue vaccine in healthy children","volume":"9","author":"Mandaric","year":"2024"},{"key":"b46","series-title":"Lancet Infect Dis","first-page":"839","article-title":"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","volume":"20","author":"Kallas","year":"2020"},{"key":"b47","series-title":"Lancet Infect Dis","first-page":"1234","article-title":"Efficacy and safety of Butantan-DV in participants aged 2\u201359 years through an extended follow-up: Results from a double-blind, randomised, placebo-controlled, phase 3, multicentre trial in Brazil","volume":"24","author":"Nogueira","year":"2024"},{"key":"b1","article-title":"Vector-Borne Diseases.","year":"2024"},{"key":"b2","series-title":"EClinicalMedicine","first-page":"100712","article-title":"Global, regional, and national dengue burden from 1990 to 2017: A systematic analysis based on the global burden of disease study 2017","volume":"32","author":"Zeng","year":"2021"},{"key":"b3","series-title":"J Travel Med","first-page":"taae089","article-title":"Epidemiology of travel-associated dengue from 2007 to 2022: A GeoSentinel analysis","volume":"31","author":"Duvignaud","year":"2024"},{"key":"b4","article-title":"Epidemiological Update for Dengue, Chikungunya and Zika in 2022.","year":"2022"},{"key":"b5","series-title":"Boletim Epidemiol\u00f3gico","first-page":"1","article-title":"Monitoramento dos casos de arboviroses urbanas transmitidas pelo Aedes.","volume":"54","year":"2023"},{"key":"b6","series-title":"PLoS Negl Trop Dis","first-page":"e0006227","article-title":"The impact of insecticide applications on the dynamics of resistance: The case of four Aedes aegypti populations from different Brazilian regions","volume":"12","author":"Garcia","year":"2018"},{"key":"b7","series-title":"Hum Vaccin Immunother","first-page":"2295","article-title":"A review of Dengvaxia\u00ae: Development to deployment","volume":"15","author":"Thomas","year":"2019"},{"key":"b8","series-title":"Lancet","first-page":"1358","article-title":"Clinical efficacy and safety of a novel tetravalent dengue vaccine in healthy children in 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Rec","first-page":"457","article-title":"Dengue vaccine: WHO position paper \u2013 September 2018","volume":"36","year":"2018"},{"key":"b14","series-title":"Lancet Reg Health Am","first-page":"100777","article-title":"Effectiveness of mass dengue vaccination with CYD-TDV (Dengvaxia\u00ae) in the state of Paran\u00e1, Brazil: Integrating case-cohort and case-control designs","volume":"35","author":"Diaz-Quijano","year":"2024"},{"key":"b15","series-title":"Paediatr Int Child Health","first-page":"33","article-title":"The revised WHO dengue case classification: Does the system need to be modified?","volume":"32","author":"Hadinegoro","year":"2012"},{"key":"b16","series-title":"PLoS Negl Trop Dis","first-page":"e0004705","article-title":"Sensitivity of the dengue surveillance system in Brazil for detecting hospitalized cases","volume":"10","author":"Coelho","year":"2016"},{"key":"b17","series-title":"Cad Saude Publica","first-page":"257","article-title":"Going open source: Some lessons 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