Wednesday, November 2, 2016
Singapore - HSA approves world's first dengue vaccine for use in Singapore
A box of Dengvaxia being shown to AFP reporters at a hotel in Mexico City.PHOTO: AFP
The Health Sciences Authority (HSA) has approved the world's first dengue vaccine Dengvaxia for use in Singapore following a seven-month expedited review of the potential benefits and risks.
It will be made commercially available in several months' time. Sanofi has not yet said how much it will cost, although its its head of Global Medical Affairs, Dr Ng Su-Peing, has said that the company’s goal is to make the vaccine “as commercially accessible as possible”.
Studies have shown that overall, the vaccine is effective at reducing dengue by 60 per cent, and reducing severe dengue by 84 per cent.
Against the Den-1 and Den-2 strains – which account for three-quarters of the dengue cases in Singapore – the vaccine’s efficacy is 50 per cent and 40 per cent respectively, compared with 75 and 77 per cent for the other two strains.
The HSA's decision to approve the vaccine was based on 24 clinical studies carried out by Sanofi Pasteur - the company manufacturing the vaccine - which involved 41,000 people.
The vaccine is approved for use in anyone aged 12 to 45 years, as studies showed that the risk of hospitalisation from dengue was reduced in those above 12 years old but also showed that the vaccine was not very effective in those aged above 45.
The HSA said it is prepared to revise its age guidelines when more data is available.
Importantly, the vaccine was also 81 per cent effective in people who had already had a dengue infection previously, compared to 38 per cent in those who had never had the virus.
Younger children who had never had dengue also ran a higher risk of hospitalisation if they contracted the virus after being vaccinated, although this was not seen in older children.
The HSA therefore advises those who have not had dengue to speak with their doctors on whether or not they should get the vaccine.
The Health Ministry does not recommend rolling out this dengue vacine as a national programme as it "would not be a clinically and cost-effective means to tackling dengue infection in Singapore". This means that subsidises and Medisave cannot be used to pay for vaccination.
Professor Ooi Eng Eong, who is deputy director of the emerging infectious diseases programme at Duke-NUS Medical School, said: “The impact vaccination would have on the overall incidence of dengue in Singapore will depend tremendously on the number of people who become vaccinated.
“The larger this number, the greater impact vaccination would have on reducing the number of dengue cases in Singapore,” said Prof Ooi, who is also a scientific advisory board member on dengue for Sanofi.
The vaccine was launched late in 2015 and is currently approved for use in nine other countries, including Indonesia and the Philippines.