title: First Experience of Concomitant Vaccination Against Dengue and MMR in Toddlers.
abstract: BACKGROUND
  Dengue is a major public health concern in pediatric populations in endemic regions. A recombinant, live, attenuated, tetravalent dengue vaccine (CYD-TDV) is under development for the control of dengue with a 3-dose (0-6-12 month) vaccination schedule.
  
  
  METHODS
  In this controlled phase II trial conducted in the Philippines, 210 toddlers aged 12-15 months were randomized to 4 groups: 3 groups received the CYD-TDV vaccination schedule and a measles, mumps and rubella (MMR) vaccine given either concomitantly with the first CYD-TDV dose or 1 month earlier; 1 group received 3 active control vaccines. Safety and reactogenicity were assessed after each dose. Immunogenicity was assessed 30 days after vaccinations using the plaque reduction neutralization test against dengue and enzyme-linked immunosorbent assay methods against MMR antigens.
  
  
  RESULTS
  Injection site and systemic reactions occurred at similar rates across CYD-TDV groups, except for fever, which was more frequent after CYD-TDV and MMR coadministration (28.8%) compared with other groups (12-20%). Reactogenicity did not increase with subsequent CYD-TDV injections. There were no safety issues with the study vaccine. CYD-TDV achieved a balanced antibody response to all 4 dengue serotypes across the study groups, with geometric mean titers in the range of 105-124, 147-213, 311-387 and 127-160 for serotypes 1, 2, 3 and 4, respectively. CYD-TDV coadministration did not affect MMR immunogenicity (≥95% seroprotection against MMR) and vice versa.
  
  
  CONCLUSIONS
  The CYD-TDV has an acceptable safety and immunogenicity profile in toddlers and when coadministered with MMR.
authors.affiliation: From the *Clinical Department, Sanofi Pasteur, Marcy l'Etoile, France; †San Pablo City Health Office, San Pablo, Philippines; ‡Pharmacovigilance Department, Sanofi Pasteur, Lyon, France; §Clinical Department, Sanofi Pasteur, Makati, Philippines; and ¶Research Institute for Tropical Medicine, Muntinlupa City, Philippines.
authors.forename: Denis
authors.initials: D
authors.lastname: Crevat
authors.forename: Job D
authors.initials: JD
authors.lastname: Brion
authors.forename: Sophia
authors.initials: S
authors.lastname: Gailhardou
authors.forename: Thelma M
authors.initials: TM
authors.lastname: Laot
authors.forename: Maria Rosario
authors.initials: MR
authors.lastname: Capeding
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D003715:Dengue; D053059:Dengue Vaccines / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology; D014766:Viremia
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D053059:Dengue Vaccines; D022542:Measles-Mumps-Rubella Vaccine