Dengue infections in Malaysia have surged 56.2 per cent this year, with 58,079 cases and 55 deaths recorded so far, even as take-up of the dengue vaccine remains low.Dr Shanmuganathan TV Ganeson, president of the Federation of Private Medical Practitioners’ Associations, Malaysia, said cost was one factor behind the low vaccine uptake.A two-dose regime could cost between 420 and 500 ringgit (US$104 to US$124), depending on the facility, and was generally cheaper in general practitioner clinics, he said, adding that GPs also lag larger facilities in terms of publicity.The dengue vaccine also had to compete with other vaccines that were more affordable, he said, especially the flu vaccine.“People here tend to opt for flu protection, especially travellers, which costs less than 100 ringgit, rather than an expensive dengue vaccine,” Shanmuganathan said.He explained that the dengue vaccine could not be given to pregnant women, breastfeeding mothers or immunocompromised patients and was recommended only for those aged between four and 60.