Serotype skewing and immune imprinting shape response to the tetravalent dengue virus Qdenga vaccine

Dengue remains a major global health threat, with over 390 million annual infections. The development of safe, effective, and broadly protective vaccines has been hindered by the need for tetravalent coverage and the risk of antibody-dependent enhancement (ADE). Qdenga (TAK-003) is the only dengue vaccine currently widely available globally, yet its immunological profile remains incompletely defined. Here, we characterized humoral and cellular responses, assessing the impact of the vaccine backbone and immune imprinting on vaccine-induced immunity. We conducted a longitudinal immunological study in 110 adults from a dengue-endemic region, stratified by baseline DENV serostatus, sex, and age,