Vaccination against dengue in the Dutch Caribbean islands

The committee does not advise introducing programmatic dengue vaccination in the Dutch Caribbean at this time. Based on the assessment of the framework for vaccinations and the currently available data, the committee concludes that it is unclear whether the benefits of vaccination outweigh the risks. The efficacy against serotype 4 is uncertain and specific among dengue-naïve individuals efficacy
against serotype 3 is also uncertain. This means the potential health gains are uncertain for both children and adults. There is also uncertainty about the risk of more severe dengue in dengue-naïve patients who become infected with serotype 3 or 4 after vaccination. Because the proportion of dengue-experienced children is thought to be low on the BES and CAS islands, and there are no recent data on prior infections among adults, programmatic vaccination could potentially expose many people to this risk.