HISTORY OF DENGUE VACCINE DEVELOPMENT AND LESSONS FOR PREVENTIVE HEALTHCARE POLICY

Abstract

Vaccine development has shifted dramatically from empirical approaches to molecular immunology and mRNA technology. However, dengue fever remains a major challenge due to the co-existence of four serotypes and the mechanism of antibody-dependent enhancement (ADE), wherein non-neutralizing antibodies facilitate viral entry into macrophages via FcγR receptors, thereby increasing the risk of severe disease and dengue shock syndrome. This review systematizes the evolutionary trajectory of dengue vaccine platforms (live-attenuated, recombinant, viral vector, mRNA), focusing on major candidate vaccines including Dengvaxia (CYD-TDV), Qdenga (TAK-003), and TV003/TV005. The study evaluates health governance and ethical lessons from the Dengvaxia crisis in the Philippines, while highlighting Vietnam's contributions to international phase III clinical trials and the regulatory approval of TAK-003 in 2024. The analysis indicates that the future of dengue vaccines will depend heavily on systems immunology, artificial intelligence, nanotechnology, and personalized vaccinology, posing a comprehensive test for global preventive health capacity in the 21st century