The Spanish Society of Travel Medicine and International Vaccination has just published a document outlining recommendations for dengue vaccination in travelers.
The document highlights dengue as a globally expanding infection, now present in more than 130 countries and responsible for a significant disease burden in regions such as Latin America, Southeast Asia, and the Pacific. In the context of travelers, the estimated incidence is 6 symptomatic cases per 1,000 unvaccinated travelers per month of stay in endemic areas, making it the leading cause of fever in returning travelers.
Risk assessment: key to decision-making
SEMEVI emphasizes the need for individualized risk assessment, based on two main axes:
- Epidemiological situation at the destination (outbreaks, seasonality, vector burden)
- Traveler and trip characteristics (duration, type of exposure, comorbidities, access to healthcare)
In this context, risk is considered low for short, conventional trips without active outbreaks, but increases in scenarios such as prolonged travel, cooperation missions, VFR (visiting friends and relatives), or intense mosquito exposure.
Vaccination: a new tool in prevention
The availability of a new tetravalent vaccine, approved by the European Medicines Agency in 2022, introduces a new dimension in dengue prevention for travelers. In Spain, its use has been possible since 2023, with approximately 40,000 doses administered to date.
Efficacy data show:
- Protection against confirmed dengue: up to 80.2%
- Protection against hospitalization: up to 95.4%
- Sustained long-term efficacy, although lower in seronegative individuals
Additionally, early onset of protection after the first dose is highlighted, which is particularly relevant for travelers with limited time before departure.
Indications and practical considerations
SEMEVI recommends vaccination in higher-risk travelers, especially when factors such as the following converge:
- Destinations with high transmission or active outbreaks
- Prolonged or frequent travel
- Comorbidities or increased risk of severe disease
- Limited access to healthcare at the destination
The document also underlines key points:
- The vaccine does not replace mosquito protection measures
- Routine pre-vaccination serological screening is not generally recommended
- There is currently no evidence to recommend booster doses
- Contraindicated in pregnancy, breastfeeding, and severe immunosuppression
A dynamic approach in travel medicine
These recommendations reflect a paradigm shift in dengue prevention among travelers, integrating vaccination tools with a more precise and contextualized risk assessment.
In a global scenario marked by dengue expansion and increasing international mobility, the combination of epidemiological surveillance, up-to-date information, and individualized preventive strategies will be key to reducing the impact of this disease.
Download: Recomendaciones_SEMEVI_Vacunacion_-Dengue_Abri l2026
