SynthesisBMJ open2019
Efficacy, immunogenicity and safety of a recombinant tetravalent dengue vaccine (CYD-TDV) in children aged 2-17 years: systematic review and meta-analysis.
Synthesis in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 18 citations in OpenAlex.
- Protease Inhibitors and Innate Immune Agonists as Antiviral Strategies Against Dengue and Zika Viruses.Pathogens (Basel, Switzerland) · 2026Review
- From Antibodies to Immunity: Assessing Correlates of Flavivirus Protection and Cross-Reactivity.Vaccines · 2025Review
- Dengue Vaccination: A Practical Guide for Clinicians.Vaccines · 2025Review
- Evidence map of strategies for preventing and controllingRevista panamericana de salud publica = Pan American journal of public health · 2025Review
- Current status of the development of dengue vaccines.Vaccine: X · 2025Review
- Discovery of B-cell epitopes for development of dengue vaccines and antibody therapeutics.Medical microbiology and immunology · 2022Review
- Ecological, Social, and Other Environmental Determinants of Dengue Vector Abundance in Urban and Rural Areas of Northeastern Thailand.International journal of environmental research and public health · 2021Article
- Identification and selection of immunodominant B and T cell epitopes for dengue multi-epitope-based vaccine.Medical microbiology and immunology · 2021Review
- Complex relationships between Aedes vectors, socio-economics and dengue transmission-Lessons learned from a case-control study in northeastern Thailand.PLoS neglected tropical diseases · 2020Article
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRandomised controlled trials have evaluated the recombinant tetravalent dengue vaccine (CYD-TDV). However, individual results may have little power to identify differences among the populations studied.
objectiveTo evaluate efficacy, immunogenicity and safety of CYD-TDV in the prevention of dengue in children aged 2-17 years.
designSystematic review and meta-analysis. DATA SOURCES: MEDLINE (from 1950 to 5 December 2018), EMBASE (from 1947 to 5 December 2018) and Cochrane (from 1993 to 5 December 2018). ELIGIBILITY CRITERIA OF STUDIES: Randomised trials comparing efficacy, immunogenicity and safety of CYD-TDV with placebo or other vaccines for preventing dengue cases in children aged 2-17 years. OUTCOME MEASURES: Efficacy, immunogenicity and safety of CYD-TDV. STUDY APPRAISAL AND
methodsCalculations were made of relative risk (RR) and mean difference (MD) for dichotomous and continuous outcomes, respectively. All estimates were calculated considering a 95% CI estimate. A p<0.05 was considered statistically significant.
resultsNine studies involving 34 248 participants were included. The overall efficacy of CYD-TDV was 60% (RR 0.40 (0.30 to 0.54)). Serotype-specific efficacy of the vaccine was 51% for dengue virus type-1 (DENV-1) (RR 0.49 (0.39 to 0.63)); 34% for DENV-2 (RR 0.66 (0.50 to 0.86)); 75% for DENV-3 (RR 0.25 (0.18 to 0.35)) and 77% for DENV-4 (RR 0.23 (0.15 to 0.34)). Overall immunogenicity (MD) of CYD-TDV was 225.13 (190.34 to 259.93). Serotype-specific immunogenicity was: DENV-1: 176.59 (123.36 to 229.83); DENV-2: 294.21 (181.98 to 406.45); DENV-3: 258.78 (146.72 to 370.84) and DENV-4: 189.35 (141.11 to 237.59). The most common adverse events were headache and pain at the injection site. LIMITATIONS: The main limitation of this study was unclear or incomplete data. CONCLUSIONS AND IMPLICATIONS OF KEY
findingsCYD-TDV is considered safe and able to partially protect children and adolescents against four serotypes of DENV for a 1-year period. Despite this, research should prioritise improvements in vaccine efficacy, thus proving higher long-term protection against all virus serotypes. PROSPERO REGISTRATION NUMBER: CRD42016043628.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.