Adverse responses include difficulty swallowing, chest pain, vomiting, and nausea. Contraindications that would advise against use of the device are patients who are or may be allergic to titanium, stainless steel, nickel, or ferrous iron materials. A warning advises that the device should not be used by patients who could be exposed to, or undergo, magnetic resonance imaging (MRI) because of serious injury to the patient and damage to the device.In those with symptoms that do not improve with PPIs surgery known as transoral incisionless fundoplication may help. Benefits may last for up to six years. Special populations
Pregnancy
GERD is a common condition that develops during pregnancy, but usually resolves after delivery. The severity of symptoms tend to increase throughout the pregnancy. In pregnancy, dietary modifications and lifestyle changes may be attempted, but often have little effect. Some lifestyle changes that can be implemented are elevating the head of the bed, eating small portions of food at regularly scheduled intervals, reduce fluid intake with a meal, avoid eating 3 hours before bedtime, and refrain from lying down after eating. Calcium-based antacids are recommended if these changes are not effective, aluminum- and magnesium hydroxide -based antacids are also safe. Antacids that contain sodium bicarbonate or magnesium trisilicate should be avoided in pregnancy. Sucralfate has been studied in pregnancy and proven to be safe  as is ranitidine and PPIs.
Dengue vaccine is a vaccine used to prevent dengue fever in humans. Development of dengue vaccines began in the 1920s, but was hindered by the need to create immunity against all four dengue serotypes.As of 2021, one version is commercially available, known as CYD-TDV, and sold under the brand name Dengvaxia. The vaccine is only recommended in those who have previously had dengue fever or populations in which most people have been previously infected. The value of the vaccine is limited by the fact that it may increase the risk of severe dengue in those who have not previously been infected. In 2017, more than 733,000 children and more than 50,000 adult volunteers were vaccinated with CYD-TDV regardless of serostatus, which led to a controversy.In March 2021, the European Medicines Agency accepted the filing package for vaccine candidate TAK-003, which is designated for people not previously infected.There are other vaccine candidates in development including live attenuated, inactivated, DNA and subunit vaccines. History
In December 2018, Dengvaxia was approved in the European Union.In May 2019, Dengvaxia was approved in the United States as the first vaccine approved for the prevention of dengue disease caused by all dengue virus serotypes (1, 2, 3 and 4) in people ages nine through 16 who have laboratory-confirmed previous dengue infection and who live in endemic areas.