Not for intravascular inj. May not protect all vaccinees; continue personal protection measures against mosquito bites after vaccination. Follow-up & appropriately manage any vaccines w/ signs & symptoms of dengue fever w/ particular attention to dengue warning signs (eg, high fever, severe abdominal pain or tenderness, persistent vomiting, mucosal bleeding, somnolence & hyperactivity). Not to be used on individuals not previously infected by the dengue virus; increased risk of hospitalization for dengue & clinically severe dengue in individuals not previously infected by dengue virus. Confirm previous infection by a test before vaccination in the absence of documented prior dengue virus infection. Limit testing prior to vaccination to individuals who have been in potential contact w/ dengue virus (eg, individuals who lived before or had recurrent stay in endemic areas) & who are likely to be exposed to dengue in the future. Wait until immune function has recovered in patients receiving high doses of systemic corticosteroids given for ≥2 wk. Not recommended for individuals living in non-endemic areas, who have not been in potential contact w/ dengue virus & who only occasionally travel to endemic areas. Individuals w/ a history of serious or severe reactions w/in 48 hr after a prior administration. Syncope may occur following or before any vaccination; place procedures to prevent injury from falling & to manage syncopal reactions. Women of childbearing age should avoid becoming pregnant for 4 wk after vaccination. Not to be administered in childn <12 yr.
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