Serotype-structured force of infection for optimizing dengue vaccine trial design

In endemic dengue settings, a serotype-structured force of infection framework shows vaccine efficacy trials can reach at least 80% power with 5,000–10,000 participants per arm within 12–24 months in high-transmission areas.

• Why it matters: Trial efficiency is hard to achieve in endemic regions because transmission intensity and baseline immunity vary by location and time, and symptomatic endpoint accrual depends on local FoI.
• What they did: The team simulated trial planning by linking FoI to age-specific seroprevalence using a catalytic model, then converting FoI into symptomatic incidence for randomized controlled trial power and sample-size evaluations across low-to-high FoI scenarios.
• The result: Sensitivity analyses indicate feasibility thresholds are most sensitive to FoI and the symptomatic fraction, supporting site selection and surveillance intensity choices to optimize dengue vaccine trial design.

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