{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T12:44:27Z","timestamp":1782737067935,"version":"3.54.5"},"posted":{"date-parts":[[2026,6,26]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":44,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Stavros Niarchos Foundation Institute for Global Infectious Disease"},{"name":"Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health","award":["P01 AI106695"],"award-info":[{"award-number":["P01 AI106695"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,6,26]]},"abstract":"<jats:title>Summary<\/jats:title>\n                <jats:p>Dengue remains a major global health threat, with over 390 million annual infections. The development of safe, effective, and broadly protective vaccines has been hindered by the need for tetravalent coverage and the risk of antibody-dependent enhancement (ADE). Qdenga (TAK-003) is the only dengue vaccine currently widely available globally, yet its immunological profile remains incompletely defined. Here, we characterized humoral and cellular responses, assessing the impact of the vaccine backbone and immune imprinting on vaccine-induced immunity. We conducted a longitudinal immunological study in 110 adults from a dengue-endemic region, stratified by baseline DENV serostatus, sex, and age, including older adults (\u226565 years), a population excluded from efficacy trials. Plasma and PBMCs were collected before and up to five months after Qdenga vaccination to assess neutralizing antibody titers, B cell dynamics, and virus-specific T cell responses. Although Qdenga elicited B and T cell activation and memory formation across groups, our findings revealed serostatus-dependent and serotype-skewed humoral immunity. Only 8% of DENV-na\u00efve individuals developed tetravalent responses, while one-third responded to a single serotype, almost exclusively DENV-2, the vaccine backbone. In contrast, DENV-previously exposed individuals mounted broader responses shaped by baseline serotype-specific immunity, yet neutralization against DENV-4 remained uniformly poor. Neutralizing antibody titers plateaued after the first vaccination, with no substantial increase following the second dose. These findings clarify why balanced tetravalent immunity is rarely achieved with Qdenga and demonstrate that both immune imprinting and vaccine backbone skewing limit the breadth and magnitude of the responses. This has important implications for deployment strategies, long-term protection in DENV-na\u00efve populations, and the need for booster strategies focusing on tetravalent coverage, especially for DENV-4.<\/jats:p>","DOI":"10.64898\/2026.06.15.26355542","type":"posted-content","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:25:14Z","timestamp":1782516314000},"source":"Crossref","is-referenced-by-count":0,"title":["Serotype skewing and immune imprinting shape response to the tetravalent dengue virus Qdenga vaccine"],"prefix":"10.64898","author":[{"given":"Luciana","family":"Conde","sequence":"first","affiliation":[{"name":"Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valter","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joao CR","family":"Freitas","sequence":"additional","affiliation":[{"name":"Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jameson","family":"Crandell","sequence":"additional","affiliation":[{"name":"Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Lawres","sequence":"additional","affiliation":[{"name":"Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda","family":"Tana","sequence":"additional","affiliation":[{"name":"Departamento de Fisiologia e Biof\u00edsica, Instituto de Ci\u00eancias Biol\u00f3gicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mallery I.","family":"Breban","sequence":"additional","affiliation":[{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Polster","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Yale University School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahima","family":"Akther","sequence":"additional","affiliation":[{"name":"Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbey","family":"Porzucek","sequence":"additional","affiliation":[{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tauyne M","family":"Ramiro","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Pesquisas em Virologia, Departamento de Doen\u00e7as dermatol\u00f3gicas, Infecciosas e Parasit\u00e1rias, Faculdade de Medicina de S\u00e3o Jos\u00e9 do Rio Preto, S\u00e3o Jos\u00e9 do Rio Preto, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana B","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Pesquisas em Virologia, Departamento de Doen\u00e7as dermatol\u00f3gicas, Infecciosas e Parasit\u00e1rias, Faculdade de Medicina de S\u00e3o Jos\u00e9 do Rio Preto, S\u00e3o Jos\u00e9 do Rio Preto, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1102-2419","authenticated-orcid":false,"given":"Mauricio L","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Pesquisas em Virologia, Departamento de Doen\u00e7as dermatol\u00f3gicas, Infecciosas e Parasit\u00e1rias, Faculdade de Medicina de S\u00e3o Jos\u00e9 do Rio Preto, S\u00e3o Jos\u00e9 do Rio Preto, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan D","family":"Grubaugh","sequence":"additional","affiliation":[{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA"},{"name":"Center for Infection and Immunity, Yale University, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro RJ","family":"Almeida","sequence":"additional","affiliation":[{"name":"Departamento de Fisiologia e Biof\u00edsica, Instituto de Ci\u00eancias Biol\u00f3gicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Weiskopf","sequence":"additional","affiliation":[{"name":"Center for Vaccine Innovation, La Jolla Institute for Immunology (LJI), La Jolla, CA, USA"},{"name":"Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego (UCSD), La Jolla, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro M","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Departamento de Fisiologia e Biof\u00edsica, Instituto de Ci\u00eancias Biol\u00f3gicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Lucas","sequence":"additional","affiliation":[{"name":"Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA"},{"name":"Center for Infection and Immunity, 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