Beyond The 5S: Understanding the 2nd generation dengue vaccine’s role in comprehensive dengue prevention

As climate change accelerates, the spread of dengue fever is becoming more widespread, with rising temperatures expanding mosquito habitats and increasing the risk of outbreaks. The World Economic Forum urges the implementation of innovative interventions and stronger public health measures to address this growing threat, which now affects both tropical and non-tropical regions.

In the Philippines, there were 340,860 confirmed dengue cases from January 1 to November 16, 2024, according to the Department of Health. Cases increased across various regions, including the National Capital Region, Central Luzon, and Calabarzon. The Philippine Medical Association (PMA) has emphasized the importance of strengthening integrated approach including vector control, public education, and vaccination, citing dengue’s resurgence as a major public health concern.

With rising dengue cases, a second-generation vaccine is crucial for Filipinos, offering a more effective way to prevent the disease and supporting public health efforts amid lingering distrust after the 2018 Dengvaxia controversy. The Philippine Medical Association (PMA) has reaffirmed its commitment to strengthening vaccination efforts in the country, emphasizing the critical role of immunization in preventing vaccine-preventable diseases (VPDs) like dengue, measles, and mumps. The PMA urged the medical community to restore public trust in vaccines by relying on evidence, research, and data to promote accurate information and reassure patients about vaccine safety. Backing initiatives like the Department of Health’s “Oplan Balik-Eskwela” program, the PMA underscored the importance of vaccination for children and adults alike, alongside fostering trust in regulatory agencies to ensure vaccine efficacy and safety.

As dengue cases continue to affect hundreds of thousands across the Philippines, a comprehensive approach to prevention has never been more crucial. The widely practiced 5S method—search and destroy, self-protection, seek early consultation, support fogging, and sustain hydration—remains a cornerstone of dengue control. Yet, experts emphasize that more is needed to truly curb this common, sometimes severe disease.

A safer, broader strategy for dengue prevention

One key innovation is the introduction of a new, second-generation dengue vaccine, which offers protection without the limitations faced by earlier vaccines. The latest option brings hope for a broader range of individuals to be immunized and protected against dengue, regardless of prior exposure to the virus.

“The second-generation dengue vaccine addresses issues previously associated with first generation vaccines,” explains Dr. Anna Ong-Lim, an infectious disease specialist. “With this new vaccine, there’s no longer a need to determine if a person has had dengue before getting vaccinated. It’s safe for both those who’ve had dengue before and those who haven’t.”

The new vaccine’s profile is a major step forward from the first-generation vaccine, which required healthcare providers to check for prior infection. Without this screening, those without a previous dengue infection, known as “seronegative” patients, faced a risk of developing severe dengue if vaccinated. However, the second-generation vaccine eliminates that concern, making immunization accessible without testing for past infection.

According to Dr. Ong-Lim, previous studies created some misconceptions around “severe dengue” that don’t necessarily apply to the new vaccine. “The term ‘severe dengue’ can sound alarming, but in many cases, it doesn’t mean life-threatening,” she says. “Earlier research defined it broadly, even including milder cases that don’t always require hospitalization.” This distinction is essential for the public to understand, she adds, so that awareness of past challenges with dengue vaccines doesn’t prevent people from using the improved, safer vaccine now available.

Expanding accessibility and understanding of second-generation dengue vaccine

For Dr. Ong-Lim, the second-generation vaccine represents a powerful addition to existing dengue prevention strategies. She compares it to other preventive measures taken in infectious diseases, such as COVID-19, where vaccines complement practices like physical distancing. “In high-risk diseases, prevention options are critical. When you have the chance to lower your risk with a vaccine, it’s a valuable opportunity,” she notes.

Some may wonder if they can still benefit from the new vaccine if they’ve previously contracted dengue—an important question in a country where many cases go undetected. Dr. Ong-Lim clarifies that the answer is yes. “Even if you think you haven’t had dengue, there’s a chance you were exposed without symptoms,” she says. According to WHO1, many dengue infections are asymptomatic or produce only mild illness.

While the vaccine may initially be available only in private healthcare settings, Dr. Ong-Lim believes this doesn’t diminish its significance. Like the chickenpox vaccine, which is available privately in the Philippines, the dengue vaccine can still provide crucial protection for those who choose to receive it.

Dr. Ong-Lim encourages people to discuss the vaccine with healthcare providers, emphasizing that a well-informed public will make better choices. “It’s essential to consult with your physician to understand the benefits and risks and get answers to any questions you may have,” she advises. “With better knowledge about the options available, individuals can make decisions with confidence.”

For now, the Philippines has the opportunity to take a significant step forward in its fight against dengue. Holistic dengue prevention includes education, immunization, and diligent practice of preventive measures like the 5S. By strengthening the country’s defenses, Filipinos can face dengue season with increased confidence—and hope that, with continued efforts, they can turn the tide against this unpredictable disease.

References:
World Health Organization. Dengue and severe dengue. 24 April 2024.

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