Dengue vaccines lower viremia rates and hemorrhagic fever risk compared to placebo in a meta-analysis of 175434 participantsDengue vaccines show lower rates of infection and severe fever compared to placebo

Acta tropica Published June 1, 2026 Study authors: Pizzol Damiano, Rahmati Masoud, Malakoutinia Fatemeh, Boyer Laurent, Fond Guillaume, Caminada Susann… PubMed ↗ DOI ↗ Editorial oversight: Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

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Key Takeaway

Note dengue vaccines reduce viremia and hemorrhagic fever risk with a favorable safety profile compared to placebo.

This meta-analysis evaluated the efficacy and safety of dengue vaccines compared to a placebo group. The analysis included data from 175434 participants. The study examined secondary outcomes including viremia, hemorrhagic fever, antibody production, serious adverse events, injection site reactions, and systemic side effects. Follow-up duration was not reported. Funding or conflicts of interest were not reported.

The analysis demonstrated a protective effect for viremia with an odds ratio of 0.35 and a 95 %CI of (0.25, 0.48), p < 0.00001. The rate of hemorrhagic fever was lower with an odds ratio of 0.16 and a 95 %CI of (0.09, 0.28), p < 0.00001. Antibody production showed a high percentage, though specific effect sizes were not reported.

Safety analysis revealed adverse events such as swelling, erythema, pruritus, rash, asthenia, myalgia, arthralgia, malaise, nausea, and neutropenia. There was no significant difference in serious adverse events when compared to the placebo group. Tolerability was described as promising. Discontinuations were not reported. The authors noted that causality was not reported and certainty was not reported.

This meta-analysis looked at data from many studies involving 175,434 people who received dengue vaccines or a placebo. The goal was to see how well the vaccines worked and if they were safe. The researchers found that vaccinated people had a lower rate of viremia, which is the presence of the virus in the blood. They also had a lower rate of hemorrhagic fever, a severe form of dengue. The odds of getting infected were much lower for those who got the vaccine compared to the placebo group.

The vaccines also helped the body produce more antibodies, which are proteins that fight off infections. This suggests the vaccines help the immune system recognize and fight the dengue virus more effectively. The study looked at several secondary outcomes to get a full picture of the vaccine's effects.

Regarding safety, the vaccines caused common side effects like swelling, redness, itching, rash, fatigue, muscle pain, joint pain, general feeling of being unwell, nausea, and low white blood cell counts. However, there was no significant difference in serious adverse events between the vaccine group and the placebo group. The overall tolerability of the vaccines was described as promising based on these results.

What this means for you:

Vaccines lower dengue infection risk and severe fever rates with common side effects like swelling and fatigue.

Study Details

Study typeMeta analysis

Sample sizen = 175,434

EvidenceLevel 1

PublishedJun 2026

PMID41912000

View Original Abstract ↓

Over recent decades the incidence of dengue has increased on a global scale and in 2023 reached unprecedented levels. One potential promising approach to prevent dengue and reduce dengue symptoms is vaccination. We systematically searched PubMed/Medline, Scopus, Embase, Web of Science, Cochrane, and Lilacs databases from inception to the 27 of July 2025 (PROSPERO registration CRD42024579006). Outcomes were pooled and expressed as odds ratio (OR) with corresponding 95 % confidence intervals (CI). Meta-analysis was conducted for each outcome using Review Manager and the grading of evidence was carried out using the GRADE. We included 42 studies with a total of 175,434 participants. Efficacy of vaccine was demonstrated by the lower rate of viremia OR = 0.35, 95 %CI (0.25, 0.48), p < 0.00001, hemorrhagic fever OR = 0.16, 95 %CI (0.09, 0.28), p < 0.00001and high percentage of antibody production. In terms of safety, all vaccines showed promising results with no significant difference in serious adverse events when compared to placebo group. A higher rate of reaction at the injection site was reported only for swelling, erythema, pruritus, and rash. Asthenia, myalgia, arthralgia, malaise, nausea, and neutropenia were identified systemic side effects reported with a higher rate in the vaccinated group. Our findings suggest that dengue vaccination is potentially both safe and efficacious.

Dengue vaccines lower viremia rates and hemorrhagic fever risk compared to placebo in a meta-analysis of 175434 participantsDengue vaccines show lower rates of infection and severe fever compared to placebo

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Dengue vaccines lower viremia rates and hemorrhagic fever risk compared to placebo in a meta-analysis of 175434 participantsDengue vaccines show lower rates of infection and severe fever compared to placebo

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