The introduction of new vaccines into developing countries. V: Will we lose a decade or more in the introduction of dengue vaccines to developing countries?

• We have examined prelicensure activities that can accelerate vaccine introduction.
• We show that a number of these activities are essential for timely introduction.
• We conclude the public sector should generously support prelicensure introduction activities.

Dengue results in as many as 390 million infections annually and causes significant morbidity. A number of efforts are underway to develop vaccines against dengue. The public sector is undertaking efforts to create an enabling environment for vaccine introduction. Recent work by Brooks et al. provides a framework for analyzing which efforts should be undertaken before licensure. They conclude that actions before licensure are required to eliminate the decade or more it normally takes to introduce new vaccines into developing countries. We apply their methodology to dengue and identify a number of critical areas where public sector actions before licensure can greatly accelerate vaccine uptake.