The Malaysian Health Ministry reported more than 120,000 dengue fever cases in 2015. In 2016 to date, the case tally exceeds 41,000 through Apr. 17, including 90 fatalities.

Aedes aegypti/CDC
Aedes aegypti/CDC

The high number of dengue cases in Malaysia calls into question, Will the country, like neighboring Asian nation the Philippines, institute the dengue vaccine as part of the disease prevention program?

Last week, the Strategic Advisory Group of Experts (SAGE) on immunization met on 12-14 April 2016 in Geneva, Switzerland.

SAGE recommended countries consider introduction of CYD-TDV (Dengvaxia®) only in geographic settings (national or subnational) with high endemicity, as indicated by seroprevalence of approximately 70% or greater in the age group targeted for vaccination or other suitable epidemiologic markers.

Dengue vaccine introduction should be a part of a comprehensive dengue control strategy together with a communication strategy, well-executed and sustained vector control, the best evidence-based clinical care for all patients with dengue, and robust dengue surveillance.

Decisions about introduction require careful assessment at the country level, including consideration of local priorities, national and subnational dengue epidemiology, predicted impact and cost-effectiveness with country-specific hospitalization rates and costs, affordability and budget impact.

In Malaysia, lawmaker Charles Santiago said, “The government should allow its entry and make it available, maybe at a subsidized price. Given the recent RM300 million cut in the Health Ministry’s budget, I’m not so sure it’ll make the effort to purchase the vaccines, or even if they do, whether it will subsidize it.”

Joachim Hombach, the senior adviser in WHO’s Initiative for Vaccine Research, said as reported in Free Malaysia Today, “You need to buy the vaccine and it costs a lot of money.

“You don’t want to be in a situation where you introduce a vaccine and then two years later you say, oops, sorry, we are running out of money and we have to stop this programme,” Joachim said.