ArticlePLoS neglected tropical diseases2021
Cost-effectiveness of dengue vaccination in Puerto Rico.
Article in PLoS neglected tropical diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Therapeutic approaches against dengue virus: current status of vaccines, antivirals, and monoclonal antibodies.Emerging microbes & infections · 2026Review
- Cost-effectiveness of chikungunya vaccination with the live attenuated vaccine in U.S. territories.NPJ vaccines · 2025Article
- Vaccination strategies, public health impact and cost-effectiveness of dengue vaccine TAK-003: A modeling case study in Thailand.PLoS medicine · 2025Article
- Occupational exposure to malaria, leishmaniasis and arbovirus vectors in endemic regions: A systematic review.Current research in parasitology & vector-borne diseases · 2024Review
- Article
- Predominance of Severe Plasma Leakage in Pediatric Patients With Severe Dengue in Puerto Rico.The Journal of infectious diseases · 2022Article
- "To do, or not to do?": determinants of stakeholders' acceptance on dengue vaccine using PLS-SEM analysis in Malaysia.BMC public health · 2022Article
- Dengue Vaccine: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021Article
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Authors and funding
4 authors.
Funding
Abstract
An effective and widely used vaccine could reduce the burden of dengue virus (DENV) around the world. DENV is endemic in Puerto Rico, where the dengue vaccine CYD-TDV is currently under consideration as a control measure. CYD-TDV has demonstrated efficacy in clinical trials in vaccinees who had prior dengue virus infection. However, in vaccinees who had no prior dengue virus infection, the vaccine had a modestly elevated risk of hospitalization and severe disease. The WHO therefore recommended a strategy of pre-vaccination screening and vaccination of seropositive persons. To estimate the cost-effectiveness and benefits of this intervention (i.e., screening and vaccination of seropositive persons) in Puerto Rico, we simulated 10 years of the intervention in 9-year-olds using an agent-based model. Across the entire population, we found that 5.5% (4.6%-6.3%) of dengue hospitalizations could be averted. However, we also found that 0.057 (0.045-0.073) additional hospitalizations could occur for every 1,000 people in Puerto Rico due to DENV-naïve children who were vaccinated following a false-positive test results for prior exposure. The ratio of the averted hospitalizations among all vaccinees to additional hospitalizations among DENV-naïve vaccinees was estimated to be 19 (13-24). At a base case cost of vaccination of 382 USD, we found an incremental cost-effectiveness ratio of 122,000 USD per QALY gained. Our estimates can provide information for considerations to introduce the CYD-TDV vaccine in Puerto Rico.
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