Combining vaccination with w Mel for dengue control in Brazil

Dengue virus is a severe threat to global health. Novel vaccine and Wolbachia technologies offer a potential path to dengue control; however, it remains unclear how to use these approaches in tandem. Using metapopulation transmission models, we simulated future dengue burden in Brazil. We estimated that w Mel releases in 300 municipalities could avert 12-22% of cases over the next 10 years, while a national vaccination campaign could avert 8-10% of cases in the total population and 39-45% within the vaccinated cohort. Projecting forward 40 years, we found w Mel releases would drive up the mean age of cases beyond increases due to the ageing population and increase population susceptibility to dengue. Finally, w Mel releases can help mitigate the future burden in southern Brazil where climate change is rapidly increasing dengue virus risk. These findings highlight the need to consider the two technologies in parallel to optimise efforts to combat future dengue burden.