Neutralizing Dengue Antibodies after 10 years of the Chimeric Yellow Fever Tetravalent Dengue Vaccine (CYD-TDV) and Dengue Antibody Cross-reactivity with SARS-CoV-2 in Indonesia.

Publication date: Jul 31, 2026

Dengue endemic countries were affected by the spread of COVID-19. In 2011, Indonesia participated in a multi-center phase III clinical trial of chimeric yellow fever tetravalent dengue vaccine (CYD-TDV). This study evaluates neutralizing dengue antibodies of CYD-TDV after 10 years during COVID-19 pandemic. To assess neutralizing antibody against all four-dengue virus (DENV) serotypes and dengue incidence in individuals who received CYD-TDV after 10 years immunization in Indonesia. Additionally, to compare SARS-CoV-2 neutralizing antibody titers and COVID-19 incidence between dengue-vaccinated and non-vaccinated groups. This study was conducted across five healthcare centers in Jakarta (June-December 2022) involving 419 participants (207 dengue-vaccinated, 212 non-vaccinated). A cross-sectional study in subset of 79 dengue-vaccinated and 80 non-vaccinated participants were measured neutralizing antibodies against DENV and SARS-CoV-2, respectively. Simultaneously, all participants were given questionnaires to assess dengue and COVID-19 history. In adolescents (12-17 years), CYD-TDV recipients had significantly higher neutralizing antibody titers against DENV-1, DENV-2, and DENV-4, but not DENV-3. While, no significant differences were observed in adults (≥18 years) in both groups. Dengue incidence was similar between dengue-vaccinated (4. 8%) and non-vaccinated (5. 1%) groups. The SARS-CoV-2 neutralizing antibody levels were not significantly different between groups. However, Incidence of hospitalized COVID-19 were higher in the dengue-vaccinated group. After a decade, CYD-TDV induced higher neutralizing antibody levels significantly for DENV-1, DENV-2, and DENV-4, but not for DENV-3 in adolescents but not in adults. The SARS-CoV-2 neutralizing antibody levels were comparable between groups, However, COVID-19 hospitalizations were more frequent in dengue-vaccinated group.

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