Drug Interaction Report

ADJUST DOSING INTERVAL: The safety, immunogenicity, and efficacy of dengue vaccine when administered concurrently with other live viral or bacterial vaccines have not been adequately assessed. The U.S. Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices has reported that the live, attenuated, chimeric tetravalent dengue vaccine (Dengvaxia) did not have any safety issues or decreased immunogenicity when administered concomitantly with a yellow fever vaccine or a measles, mumps, and rubella (MMR) vaccine in infants and toddlers. However, a clinical study of a different live, attenuated, tetravalent dengue vaccine (Qdenga) in adults (n=300) reported a reduction in dengue antibody responses when administered concurrently with yellow fever 17D vaccine but no effect on the yellow fever seroprotection rate. The clinical significance of these findings is unknown. Clinical data evaluating the concomitant or sequential administration of dengue vaccine with other live vaccines are not available.

MANAGEMENT: The CDC's Advisory Committee on Immunization Practices generally recommends that doses of injectable, live attenuated vaccines not administered simultaneously be separated by an interval of at least 28 days. Current local immunization guidelines and prescribing information for individual vaccines should be consulted for specific recommendations.