Dengvaxia is a live-attenuated vaccine. Live virus vaccines are generally not recommended during pregnancy; however, people infected with DENV during pregnancy are at increased risk of severe dengue. Perinatal transmission may occur with peripartum maternal infection increasing the risk of symptomatic illness in the newborn. The ACIP recommendations classify pregnancy as a precaution to vaccination with Dengvaxia.
Pregnant people were not explicitly enrolled and studied in the Dengvaxia vaccine trials. A minimal number of pregnant women in the trial inadvertently received Dengvaxia. There was no increased frequency of adverse pregnancy outcomes (e.g., spontaneous abortion, intrauterine death, stillbirth) noted compared to the control group. However, due to the small sample size, no conclusions can be made on the possible effect of Dengvaxia on pregnancy.
Providers should consider the pregnant person’s risk of DENV infection and its complications when deciding whether or not to recommend Dengvaxia during pregnancy or to defer until after pregnancy.