With no suitable vaccine in sight, Bangladesh focuses more on clinical care to fight dengue 

With dengue deaths being reported daily and infections spreading rapidly beyond Dhaka, health authorities are prioritising clinical management since an effective vaccine for all age groups still remains unavailable.

Speaking to The Business Standard, Dr Md Abu Jafor, director general of the Directorate General of Health Services (DGHS), said the government is not considering vaccine rollout at this stage because "dengue vaccines are still under research in many areas" and "there is no effective vaccine for all age groups." 

Infographics: TBS

While some countries are administering dengue vaccines in limited settings, "no country is providing it widely," he added.

Professor Jafor emphasised that aggressive mosquito control and public awareness remain critical. "Anyone with a fever should seek medical advice immediately. If patients arrive late, there is nothing we can do at the final stage," he said.

He noted that authorities are working to respond to outbreaks in high-incidence areas. Hospitals, he said, have adequate saline supplies, and the NS1 dengue test has been made free. "If we do not stay collectively vigilant, it will be difficult to manage the situation," he warned.

With three more deaths reported yesterday, the total number of dengue fatalities this year has reached 318, reflecting an alarming trend in the outbreak.

So far, two dengue vaccines exist globally — Dengvaxia and Qdenga — but neither is yet considered suitable for Bangladesh.

According to the World Health Organization (WHO), Qdenga (TAK-003) is currently the only widely recommended vaccine for dengue prevention. WHO advises its use for children aged 6-16 years in high transmission areas. 

The vaccine requires two doses, three months apart, and is now available in private markets in 24 countries, including Indonesia, Thailand, and several European nations. 

Dengvaxia, meanwhile, has been approved in 19-21 countries, including Brazil and EU member states. The three-dose vaccine — administered at six-month intervals — is approved in the United States, EU, and several other countries. 

In 2024, the Brazilian city Dourados launched one of the largest dengue vaccination drives to date, targeting 150,000 people. 

Despite global advances, Bangladesh has no approved dengue vaccine programme. 

Public health expert Dr M Mushtuq Husain told TBS, "There is still no dengue vaccine suitable for our country. A second-phase trial was conducted for a vaccine developed by icddr,b, and after the third-phase trial and approval, that vaccine may become suitable for us. Until that vaccine is approved, we must focus on dengue prevention."

Dengue control and treatment services need to be decentralised, he added. 

Bangladesh's leading health research institution, icddr,b, is collaborating with the Larner College of Medicine at the University of Vermont (UVM), USA, to develop a single-dose tetravalent dengue vaccine candidate, TV005.

In September 2023, the vaccine completed its second-phase trial successfully for the first time in Bangladesh, demonstrating strong antibody responses against all four dengue serotypes.

Scientists from icddr,b and UVM said their vaccine could play a crucial role in dengue prevention in Bangladesh.

According to icddr,b sources, a decision on launching the Phase III trial of TV005 is expected next month.

Dengue situation worsens 

DGHS data show 80,634 cases so far, with 912 new hospitalisations in 24 hours as of yesterday morning. Men account for 65% of infections, and the most affected age group is 16–25. 

Death rates show 53.2% male, with a worrying concentration among children aged 0–15 years.

Public Health Specialist Prof Dr Kabirul Bashar told TBS that the outbreak is "far from under control," warning that transmission is likely to continue through November. 

He stressed shifting from fogging to full Integrated Vector Management, with trained manpower, modern equipment, and ward-level Dengue Control Taskforces to ensure monitoring and accountability.