There has been much debate on why the Government has yet to introduce the dengue vaccine in Malaysia.
Many reasons from the poor efficacy against the DEN2 serotype which is the most prevalent strain in Malaysia, to the fast that cost benefit aspect needs to be taken into account. Some also doubt the long term side effect profile, considering that this vaccine was rushed from Phase 3 into the market.
With a mortality rate of about 0.3%, some may argue that mass vaccination programmes will just not be cost effective.
The above table summarizes the trial results. It appears that the efficacy is very low in the vulnerable 2-9 year old group and extremely low efficacy agains the DEN2 serotype. Although it does appear to have very good percentages for prevention of DHF, if you look at the absolute numbers, a mass vaccination programme may not be cost effective.
It does boil down to economics. And from the looks of it, we are unlikely to see the dengue vaccine anytime soon, unless WHO unleashes a strongly worded advice.