Recent trends in climate change have led to increasingly warmer temperatures worldwide . According to the latest data from NASA , the global temperature in 2015 ranks as the warmest on record with 0.87 ° C above the average temperature in
1951-1980 . 6 In Indonesia , WHO estimates that the mean annual temperature may rise by 3.8 o C by the year 2100 due to increased carbon emissions . 7
Studies show that with this increase in temperature , the spread of the vector and the
virus will be at a larger extent , potentially increasing the global burden of dengue . 8 Warmer temperatures have been known to affect transmission of dengue in at least 2 ways ; by affecting the vector mosquitos and by affecting the virus itself . One study explains that as temperature increases , the rate of larval development increases , the emergence of mature mosquitos quickens , the biting rate of mosquito increases , and
the viral replication time within the mosquitos shortens . 9 A study by Rohani et al . in 2009 found that the time between feeding and viral detection decreased in higher
temperature , from 9 days at 26 ° C to 28 ° C to 5 days at 30 ° C for DENV-1 and DENV-4 . 10 Another study explains that a rise in temperature results in a shorter extrinsic incubation period ( EIP ), that is , the time needed for DENV to become transmissible to another host
after initial infection of a mosquito . 11 The study by Chan and Johansson in 2012 estimated that the average EIP shortens from 15 days at 25 ° C to 6.5 days at 30 ° C . 12
Currently , vector control has been the main strategy in managing dengue . According to WHO , countries should adopt an integrated management approach to vector control in order to optimize the use of resources , efficacy , cost effectiveness , ecological safety and
sustainability . 13 Current control measures target different stages of development of A . aegypti . 14 In Indonesia specifically , dengue prevention is carried out through both
vector control and early warning system . 15 Vector control includes source reduction and elimination of adult mosquitos . The source reduction program is commonly known as “ 3M – Menguras , Menutup dan Mengubur ” which means to drain , to close and to bury potential breeding sites of dengue . Additional methods include the utilization of
larvacide powder , and controlling lighting and ventilation in the house . 16
Despite all the existing vector control measures , the global spread of the disease still
persists . 13 The current rise in global temperature may eventually incapacitate these vector control measures to manage dengue incidence . This calls for a more urgent need to introduce a vaccine into the prevention scheme . When integrated with the current vector control , a safe , efficacious and cost-effective vaccine has the potential to significantly improve dengue prevention .
Several dengue vaccines have been developed in the past . However , the one that has shown most promise is the CYD-TDV ( Trade name : Dengvaxia ), which is a Tetravalent Dengue Vaccine developed by Sanofi Pasteur . This is a live-attenuated chimeric vaccine that contains all four dengue virus antigens ( DENV 1-4 ) with a yellow fever backbone . WHO recommends the introduction of this vaccine in areas where there is a high burden
of dengue disease . 17 As of April 2016 , CYD-TDV has been licensed in Mexico , Brazil , El