Estimating potential demand and supply of dengue vaccine in Brazil.

Dengue is endemic in Brazil. Several dengue vaccine candidates, including one at the Butantan Institute in Sao Paulo, are being evaluated in clinical trials and may be licensed in several years. This study estimates the potential doses of dengue vaccine needed in Brazil under different scenarios in the first 5 years after vaccine introduction. Estimates were based on 2015-2022 country population projections. An estimated country population of 200-209 million with an annual 3.3-3.5 million cohort in the 12 to 23 month age group was included in the analysis. Computations were made for vaccines requiring one, two and three doses. A total of 7.8-62.9 million doses would be needed for only routine vaccination of 12-23 months cohort in first five years with different vaccination schedules. A combination of country-wide routine 12-23 month-old vaccination plus catch-up vaccination of individuals up to 40 years age is an appropriate strategy to control dengue. For this combination strategy, 129-425 million doses would be needed in the first five years after introduction. If vaccination is not provided to areas with low incidence of dengue, an estimated 108-360 million doses would be needed. This study provides a range of vaccine uptake estimates under different scenarios based on disease epidemiology. Actual demand and uptake will depend on the country vaccine introduction policy and strategies, vaccine supply capacity, cost, and vaccine profile. We consider one option based on the availability of vaccine from different sources. A more advanced vaccine uptake model based on estimates of vaccine impact under various scenarios should be developed.