Sustained dengue transmission and seroprevalence in the U.S. Virgin Islands

Abstract Objective To estimate dengue virus (DENV) seroprevalence and assess parental vaccine perceptions among children in the US Virgin Islands (USVI). Methods A cross-sectional serosurvey was conducted during April–May 2022 among 372 children aged 8–16 years from 15 schools across USVI. Past DENV infection was determined using a dengue IgG rapid diagnostic test. Data on demographics, dengue knowledge, and vaccine acceptance were collected from parents. Catalytic models estimated annual DENV force of infection (FOI) using seroprevalence and case data from 2010–2022. Results Seroprevalence among children aged 8–13 years was 47% (95% CI: 29%, 68%). FOI peaked during 2012–2013 outbreaks and remained low in other years. Only 17% of parents were aware of an approved dengue vaccine, and 25% reported they would vaccinate their child. Conclusions Nearly half of children had prior DENV infection. Despite this risk, parental awareness of dengue vaccination was low, underscoring gaps in detection, diagnosis, and preparedness for vaccine implementation. Policy Implications These data highlight the need for enhanced surveillance, public education, and targeted planning for dengue vaccine introduction in endemic US jurisdictions.