Dengu-end is Near: An Unmatched Case Control Study on the Dengue Vaccine Efficacy and Its Association between Dengue Cases among Children Ages 9-12 in Pasig City

Lance Sese^1, , Gabriel Castillo¹, Angelica Ermino¹, Abigail Juat¹ and Rexelle Piad¹

¹Ateneo School of Medicine and Public Health, Pasig City, Philippines

Cite this paper:
Lance Sese, Gabriel Castillo, Angelica Ermino, Abigail Juat and Rexelle Piad. Dengu-end is Near: An Unmatched Case Control Study on the Dengue Vaccine Efficacy and Its Association between Dengue Cases among Children Ages 9-12 in Pasig City. American Journal of Epidemiology and Infectious Disease. 2018; 6(1):1-6. doi: 10.12691/ajeid-6-1-1

Abstract

Background and Objectives: Mass immunization program with the recently approved dengue vaccine among grade 4 students of public elementary schools commenced in April 2016. Whether an individual had prior dengue infection or not is the most important aspect when implementing this vaccine since through the mechanism of antibody-dependent enhancement (ADE), those who are seronegative or never had dengue prior that are immunized can have their first natural dengue infection to be of higher severity. Thus, this study aims to determine if immunization with the newly-licensed live, attenuated, tetravalent dengue vaccine is associated with the occurrences of hospitalization due to dengue infection. Methodology: This unmatched case control study was conducted in three tertiary hospitals within and near Pasig City, an area tagged as hotspot for dengue infection. Cases (n=112) were Filipino children, 9-12 years of age, confined to a tertiary hospital due to dengue infection and supported with a positive confirmatory test. Controls (n=112) were Filipino children of the same age group with a medical record as an outpatient or inpatient whose final diagnosis is not dengue. Chi-square test was used to determine the association between the dependent and independent variables. All statistical analysis in this study was done using SPSS 20. Results: The proportions of cases and controls that were vaccinated with dengue vaccine were 1/56 for both (only 2 out of 112). Among children of 9-12 years of age, dengue vaccine is not associated with dengue infection hospitalization (p=1.000). Only age is found to be significant among the confounders (p=0.010; 95% CI: 1.134-1.863). Conclusions: There is no significant association between dengue vaccination status and hospitalization due to dengue infection. Further evaluation of the association may require an increase in sample size, and conduct of the study a few more years after the implementation of the mass immunization program.

Keywords:
case control dengue dengue vaccine Dengvaxia Philippines

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