Human Genetics and Dengue Vaccination: Ethical, Social, and Humanistic Perspectives on Emerging Challenges and Future Directions

Abstract

Dengue virus (DENV) infection presents a critical public health crisis across tropical and subtropical regions, including Bangladesh. While clinical manifestations range from mild self-limiting febrile illness to severe dengue shock syndrome, recent bio-medical frameworks highlight the interplay between host genetic variability and vaccine efficacy. Beyond immunological mechanisms, the introduction of dengue vaccines and genetic profiling introduces complex bioethical, social, and humanistic dilemmas regarding equitable access, informed consent, and health equity. This study explores the intersection of host genetic polymorphisms and dengue vaccination strategies, critically examining the ethical, social, and humanistic challenges arising from genomic risk stratification and vaccine deployment in low- and middle-income countries (LMICs). A comprehensive analytical and bioethical narrative synthesis was conducted, re-evaluating molecular epidemiological data alongside socio-ethical frameworks. Genetic variants governing immune regulation (e.g., TNF, IL6, IL10, TLR3, TLR4, FCGR2A, CD209, and MBL2) were analyzed in conjunction with vaccination dynamics, vaccine-induced antibody-dependent enhancement (ADE), and global bioethics guidelines. Genomic risk stratification promises personalized public health interventions but risks exacerbating health disparities, genetic discrimination, and social stigma. Integrating humanistic perspectives into dengue immunization policies is vital for safeguarding vulnerable populations, maintaining institutional trust, and ensuring bioethical integrity in national health frameworks.