Public backlash against the first viable dengue vaccine Dengvaxia resulted in its suspension in the Philippines after evidence that people who were vaccinated that had not previously contracted the disease could develop a more severe form of the illness.

French drugmaker Sanofi, creator or Dengvaxia, claimed that “the vaccine works well,” according to The New York Times. “In people older than 9, Dengvaxia is about 66% effective. It is even more effective– 81.9 percent– in those over 9 who were previously infected.”

The risk is low, but fear is high in the Philippines. Parents worry about their children receiving the vaccine.

The New York Times quoted Leovon Deyro, whose youngest son received the vaccine two weeks ago: “We weren’t told it was not safe. They made my son and other students as guinea pigs.”

Deyro, among others, thinks Sanofi worked with Philippine officials to evade regulations.

Sanofi denied the allegation; however, the company does face the very real accusation of “discounting early warnings that its vaccine could put some people at heightened risk of a severe form of the disease.”

Dengue is an endemic in Latin America, Southeast Asia and the Pacific Islands– it occurs every year. Mosquitos spread the disease by carrying and transmitting any of four viruses.

“The World Health Organization (WHO) estimates that 50-100 million infections occur yearly, including 22,000 deaths, mostly among children,” the CDC reports.

The consequences of no vaccine are dangerous. The backlash against Dengvaxia could increase the general distrust of vaccines in communities that need them and in the pharmaceutical industry.

Pharmaceutical companies are already hesitant to invest in vaccines used mainly in developing countries, The New York Times said. Although 19 countries approved Sanofi’s vaccine, the suspension in the Philippines may be bad news.

Consequences of No Vaccine

Removing the vaccine would leave 90 percent of Philippine’s population “at the mercy of an epidemic which has been found to be preventable,” Thomas Triomphe, regional Sanofi official, said at a Philippine Senate hearing on Dec. 11.

Of the 90 percent, the death rates without the vaccine are highest among children.

The early symptoms of dengue include a high fever coupled with at least two other symptoms– some of which are a severe headache, joint pain, muscle/bone pain, or mild bleeding. Warning signs of a more severe situation include drowsiness/irritability, cold/pale/clammy skin, or bleeding from the nose or gums.

Dengue is not pleasant.

The Philippine government initiated sponsored vaccination campaigns in 2015. They responded to public outrage with an investigation of the immunization program.

The public questioned the government’s aggressive push to vaccinate despite warnings from experts.

“We did not give a blanket recommendation that the vaccine should be introduced,” said Dr. Gundo Weiler, WHO Country Representative to the Philippines. “This is a decision for governments and governments alone.”

Evidence existed that showed Dengvaxia could theoretically cause more severe dengue in people who had not yet contracted it, but the people receiving the vaccination were not aware.

New Hope for Dengue Vaccine

The University of Queensland and China’s ZhuJiang Hospital collaborated on a study that “identified an antibody that binds to, and kills, all four types of dengue virus.”

The study explored how protective antibodies attack dengue, and the findings could lead to more effective vaccines.

“As it recognizes all four dengue virus types, it provides the basis of a safe and broad-spectrum anti-dengue therapy as well as informing the next generation of dengue vaccines,” Dr. Daniel Watterson, joint first author of the paper with Dr. Jie Li, said.

Medicine evolves and improves, but governments of developing countries must deal with drug companies carefully to maintain the trust and safety of the public that need quality vaccines.