Epidemiology and Infection

Original Papers


Will people change their vector-control practices in the presence of an imperfect dengue vaccine?

T. M. Q. R. BOCCIAa1, M. N. BURATTINIa1, F. A. B. COUTINHOa1 and E. MASSADa1a2 c1

a1 School of Medicine, The University of São Paulo, São Paulo, SP, Brazil and LIM01 HC-FMUSP

a2 London School of Hygiene and Tropical Medicine, London University, London, UK


Human behaviours, which are influenced by social, cultural, economic and political factors, can increase or decrease the risk of dengue infection, depending on the relationship with the insect vector. Because no vaccine is currently available, the spread of dengue can only be curtailed by controlling vector populations (Aedes aegypti and others) and by protecting individuals. This study tested the hypothesis that dengue-affected populations are likely to relax their vector-control habits if a potentially protective vaccine becomes available. The hypothesis was tested using two approaches: a mathematical model designed to describe dengue transmission and an empirical field test in which the local population of an endemic area was interviewed about their vector-control habits given the presence of a theoretical vaccine. The model demonstrated that depending on the level of vector-control reduction, there is a threshold in vaccine efficacy below which it is better not to introduce the vaccine. The interview showed that people who were informed that a very effective vaccine is available would reduce their vector-control habits significantly compared to a group that was informed that the vaccine is not very effective.

(Received February 06 2013)

(Revised April 02 2013)

(Accepted May 06 2013)

(Online publication June 05 2013)

Key words

  • Dengue fever;
  • epidemiology;
  • health policy;
  • infectious disease control;
  • vaccines


c1 Author for correspondence: Dr E. Massad, School of Medicine, The University of São Paulo, Av. Dr Arnaldo 455, São Paulo, CEP 01246-903, SP, Brazil and LIM01 HC-FMUSP. (Email: edmassad@usp.br)