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[Pharmacology](https://durgical.com/en/pharmacology/) · [Viral vaccines](https://durgical.com/en/pharmacology/classes/viral-vaccines/)

# Dengue vaccine

Live attenuated tetravalent vaccines. WHO recommends TAK-003 for children aged 6–16 in high-transmission settings; CYD-TDV only after a previous infection.

Updated 2026-11-01

- Class: [Viral vaccines](https://durgical.com/en/pharmacology/classes/viral-vaccines/)
- Target: Dengue virus envelope protein (E)
- ATC code: J07BX04
- WHO Model List of Essential Medicines

Also called: TAK-003 (tetravalent), CYD-TDV (tetravalent)

◆**Dengue virus envelope protein (E)**Dengue vaccine

ⓘ The figure shows the envelope protein of dengue virus type 2; the vaccines aim to induce neutralising antibodies against the E protein of all four serotypes.

**Target in 3D:** Dengue virus envelope protein (E). PDB structure 1OAN (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/1OAN) · Drag to rotate · pinch to zoom

## Mechanism of action

There are four dengue serotypes. A second infection with a different serotype carries a higher risk of severe dengue, because non-neutralising antibodies can help the new virus. A vaccine that acts like a first infection in someone never infected could therefore raise risk later: this was seen with CYD-TDV, which is used only in people with proof of a previous infection. TAK-003 protects against all four serotypes in previously infected people, but in seronegative people protection is shown only against DENV-1 and DENV-2, and a risk with DENV-3 and DENV-4 cannot be ruled out.

- Attenuated viruses of the four serotypes are injected
- Neutralising antibodies form against each envelope protein
- Protection is most complete in people previously infected
- In seronegative people, DENV-3 and DENV-4 protection is unproven

## Pharmacokinetics

**Onset and duration**
Partial protection after the full series; breakthrough infections can still occur

## Indications

- TAK-003: children aged 6–16 in settings with high dengue burden and transmission (WHO) [Dengue →](https://durgical.com/en/conditions/dengue/)
- CYD-TDV: only people with laboratory evidence of a previous dengue infection (pre-vaccination screening) [Dengue →](https://durgical.com/en/conditions/dengue/)

## Adverse effects

### Common

- Local reactions at the injection site

### Serious (rare, important)

- CYD-TDV in seronegative people: higher risk of severe dengue at a later first natural infection
- Anaphylaxis (rare)

## Contraindications

- Congenital or acquired immunodeficiency, including immunosuppressive therapy
- Symptomatic HIV or HIV with impaired immune function
- Pregnancy and breastfeeding (TAK-003)
- CYD-TDV: no evidence of previous dengue infection

## Key interactions

**Immunosuppressive therapy (chemotherapy, high-dose systemic corticosteroids)**
Contraindicated, as with other live attenuated vaccines

**HPV vaccine and Tdap**
CYD-TDV labelling allows them to be given at the same visit

## What is monitored

- Serostatus before CYD-TDV
- Dengue warning signs if fever occurs later: the vaccine does not fully prevent disease

## Administration and safety

- Follow the product label for route and preparation
- Check which product is used: the eligibility rules of TAK-003 and CYD-TDV differ
- Check pregnancy, breastfeeding and immune status before giving
- Record the batch and product

## Nursing care

- Confirm previous dengue infection before CYD-TDV
- Ask about pregnancy, breastfeeding and immunosuppression
- Explain that vaccination does not replace mosquito control or the warning signs of dengue
- Advise avoiding pregnancy for one month after TAK-003

## Pregnancy and breastfeeding

TAK-003 is not recommended in pregnancy and pregnancy is avoided for one month afterwards; it is contraindicated during breastfeeding until data are available. Dengue itself raises the risk of pregnancy complications.

## Memory aid

"Second dengue is the dangerous one": a vaccine must not act as a risky "first dengue". CYD-TDV = test first; TAK-003 = high-transmission children 6–16.

## Test yourself

Think of the answer, then tap the question to see it.

## Why is CYD-TDV restricted to people with a previous dengue infection?

In seronegative people it acts like a first infection and increases the risk of severe dengue at the next natural infection.

## In which group and setting does WHO recommend TAK-003?

Children aged 6–16 years in settings with high dengue burden and transmission intensity.

## Against which serotypes is TAK-003 protection unproven in seronegative people?

DENV-3 and DENV-4.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/dengue-vaccine/)

## Related drugs

- [Yellow fever vaccine](https://durgical.com/en/pharmacology/yellow-fever-vaccine/)

## Related conditions

- [Dengue](https://durgical.com/en/conditions/dengue/)

[← Back to the class: Viral vaccines](https://durgical.com/en/pharmacology/classes/viral-vaccines/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [WHO position paper on dengue vaccines – May 2024](https://www.who.int/publications/i/item/who-wer-9918-203-224) (World Health Organization, 2024); [Dengue](https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue) (World Health Organization, 2025); [WHO prequalifies new dengue vaccine](https://www.who.int/news/item/15-05-2024-who-prequalifies-new-dengue-vaccine) (World Health Organization, 2024); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=J07BX&showdescription=no) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/dengue-vaccine/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/dengue-vaccine/