Supporting the cautious approval of India’s first dengue vaccine

The approval of India’s first dengue vaccine with a safety caveat is a responsible and evidence-based decision. Given the historical lessons from Dengvaxia, which led to a public health crisis when used in seronegative populations, regulators are right to prioritize safety. The vaccine has shown strong efficacy in preventing severe dengue in those already infected, offering direct protection to the majority of Indian adults who have had dengue at least once by adulthood. Making the vaccine available, even with a restriction, is far better than having no vaccine at all. It can immediately reduce hospitalizations and deaths from recurrent infections—a leading cause of severe dengue. The caveat, though inconvenient, is a manageable hurdle. Pre-vaccination serological testing is becoming more accessible and affordable. With proper training and public awareness, clinics can screen patients effectively. This approach buys time for the development of a universal dengue vaccine while delivering tangible benefits now. Pragmatically, approving a vaccine with a known risk profile that can be mitigated through screening is the smartest path forward for a disease that has no specific treatment.