ACIP Dengue Vaccine 

Workgroup

Wilbur Chen, MD, MSc

Katherine A. Poehling, MD, MPH

ACIP Members and Workgroup Co-Chairs

Advisory Committee on Immunization Practices

ACIP Meeting June 23, 2021
ACIP Dengue Vaccines Workgroup

ACIP Members

Kathy Poehling (Co-chair)

Wilbur Chen (Co-Chair)

Beth Bell

Veronica McNally

CDC Lead

Gabriela Paz-Bailey

Ex Officio Members 

Kaitlyn Morabito (NIH)

Ralph LeBlanc (FDA)

Kirk Prutzman (FDA)

Srihari Seshadri (DOD)

Liaison Representatives 

Elizabeth Barnett (AAP)

Rob Schechter (AIM)

Consultants

Edwin Asturias

Robert Atmar

Alan Barrett

Anna Durbin

Ines Esquilin

Tony Marfin

Hal Margolis

Kristen Pierce

Anita Shet 

Steve Waterman

CDC Contributors

Laura Adams

Mimi Eckert

Rachel Eidex

Susan Hills

Terri Hyde

Mike McNeil

Jorge Munoz

Erin Staples

Cindy Weinbaum 
Dengvaxia timeline

2021

ACIP vote on 

recommendation

2019 

FDA licences

dengue vaccine

2018

WHO revised 

recommendation

to screen + 

vaccinate

ACIP dengue 

vaccine 

workgroup

2017

Case-cohort 

study shows 

increase risk of 

severe dengue 

among 

serostatus

2016 

WHO/SAGE 

recommendatio

n 9-45y in high 

seroprevalence 

areas

2015

Phase 3 results 

>risk hosp. 2-5y
Dengue vaccine workgroup timeline

2017

Dengue epi and 

vaccine 

development

2018

WG on hold

Flavivirus WG 

split

Dengue Vaccine 

Workgroup is 

formed

2019

Phase 3 results

Safety & pharmacovigilance

GRADE 

Cost effectiveness 

Dengue Diagnostics

Partially effective vaccines

Dengue vaccine in Philippines

VRBPAC review 

FDA approval

2020

Vaccine acceptability

WHO global position

Feasibility

Health Equity 

2021

Dengue IgG test evaluation

Evidence to 

recommendations 

framework (EtR)

Recommendations to ACIP 
February 24-25, 2021

Importance of a specific test for 

pre-vaccination screening

• CYD-TCV vaccine presents novel challenges due to requirement of 

pre-vaccination screening

• A test for pre-vaccination dengue screening needs to be specific to 

minimize vaccination of seronegative children and sensitive to 

maximize identification of children who can benefit from the vaccine

• CDC evaluated commercially available tests and identified one ELISA 

tests and two versions of a rapid test with high specificity and 

sensitivity 

• Test performance characteristics in the MMWR with ACIP 

recommendations and on CDC website
May 5, 2021

Evidence to recommendations framework

Consensus from ACIP Dengue Vaccine Workgroup

• Dengue is an important public health problem

• Dengvaxia is an effective vaccine for seropositive children ages 9-16 

years 

• Balance of benefits and risks favors benefits

• Acceptable to target population and stakeholders

• Cost-effective strategy under the expected seroprevalence scenarios

• Will increase health equity

• Feasible to implement

• Proposal for routine recommendation for children 9-16 years 
ACIP Schedule 2021

•ACIP June 2021 Meeting

•VOTE Dengvaxia recommendations
Presentations today

Acceptability of dengue vaccine in Puerto Rico

Dr. Ines Esquilin, Professor, University of Puerto Rico, School of Medicine

Implementation of dengue vaccine in Puerto Rico

Dr. Iris Cardona, Chief Medical Officer, Department of Health, Puerto Rico

Dengue vaccine draft recommendations using the 

evidence to recommendation framework

Dr. Gabriela Paz-Bailey, CDC, NCEZID, DVBD