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There’s a lot on the line this week for Sanofi Pasteur’s troubled dengue vaccine, Dengvaxia.

On Wednesday, an expert panel that advises the World Health Organization will vote to update its recommendations outlining how and when the vaccine should be used — and, more importantly, how and when it should not be administered. A decision is expected Thursday.

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Dengvaxia is the first licensed vaccine that protects against dengue. Data generated by Sanofi shows that while the vaccine is protective for people who have previously been infected with dengue, it actually increases the risk of severe disease for people who are vaccinated when they are dengue naïve — never before infected.

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