Will the Chikungunya Vaccines Be Enough to Prevent Epidemics?

Posted on 2026-04-09

Chikungunya virus (CHIKV) is a positive-sense, single-stranded RNA alphavirus from the Togaviridae family [1]. It is a neglected tropical disease spread by mosquitoes that can have long-lasting effects. While its mortality rate is relatively low, the impact on health and quality of life of sufferers can persist for years after infection. 

Most cases present with acute fever, myalgia, headache, rash and arthralgia lasting up to 3 weeks. In some CHIKV cases, the arthralgia can persist for months or years with debilitating polyarthralgia and polyarthritis. Other complications, such as ophthalmologic, cardiac and neurological involvement, have also been described in CHIKV patients [2].  

Chikungunya virus is most common in warm, humid climates where the primary mosquito vectors, Aedes aegypti and Aedes albopictus, are found. The virus has caused major epidemics in Latin America, Asia and Africa. South America currently bears one of the highest burdens, and direct costs to the region were estimated to be around 83.6 billion USD from 2013-2015 [3]. As of December 2025, approximately 485,908 CHIKV cases and 229 CHIKV-related deaths have been reported in 16 countries/territories [4]. CHIKV cases are likely underreported due to the concurrent circulation of other arboviral diseases such as the Zika virus and Dengue virus, which often display clinically indistinguishable symptoms [5]. 

Figure 1: The Geographical distribution of CHIKV. The countries highlighted in navy represent countries with reported locally-transmitted CHIKV cases in the past 7 years, as of July 2020.

The threat posed by this disease continues to increase, as climate change, global commerce and travel affect the distribution of Aedes aegypti and Aedes albopictus. Whilst initially considered a relatively obscure virus, outbreaks of CHIKV have increased in frequency from 2000 onward, with epidemics in Reunion Island, India, Sri Lanka, Kenya, and the Philippines. The first recorded outbreak of CHIKV in Europe was in Italy in 2007, highlighting the virus’s capacity to emerge in previously non-endemic regions [7]. 

Viral Transmission  

Figure 2: The urban transmission cycle of CHIKV.

In urbanised areas, the primary route of CHIKV transmission is via a human-mosquito-human infection cycle. In this cycle, infected individuals develop high levels of viraemia, which facilitates viral uptake by female Aedes mosquitoes during blood feeding. Following ingestion, the virus undergoes replication in the mosquito midgut before disseminating to the salivary glands. Subsequent bites result in viral transmission to another human host, allowing the cycle to continue [8]. The daytime biting behaviour of Aedes mosquitoes, combined with their close association with urban environments, limits the effectiveness of traditional vector control measures such as bed nets and indoor residual insecticide sprays [9]. These factors, together with the desiccation-resistant eggs and widespread insecticide resistance, help explain why explosive outbreaks often occur following the introduction of the virus into immunologically naïve populations [10,11].

The Licensed Chikungunya Vaccines  

Figure 3: The design comparison of the IXCHIQ® and Vimkunya® vaccines. [12]. As of September 2025, there are two chikungunya vaccines that have been licensed for use: IXCHIQ® and Vimkunya®.  

IXCHIQ® was the first CHIKV vaccine to receive licensing in November 2023. This is a live-attenuated vaccine containing a genetically modified CHIKV strain with a 62-base-pair deletion in the nsP3 gene. The nsP3 protein plays a critical role in the formation of the viral replication complex; its deletion substantially reduces viral replication efficiency and overall fitness[10]. While IXCHIQ® induces robust immune responses following administration, the use of a live-attenuated platform limits its suitability for certain populations, such as immunocompromised individuals and the elderly [12,13]. 

In contrast, Vimkunya® was licensed for use in February 2025. Being a virus-like particle (VLP), this vaccine contains recombinant CHIKV structural proteins, including the capsid and the E3, E2, 6K and E proteins, which self-assemble into particles that closely resemble the structure of native CHIKV. These VLPs are able to attach to and enter host cells, thereby eliciting a protective immune response. Crucially, the absence of a viral genome prevents viral replication. As a non-replicating vaccine, Vimkunya® is therefore more suitable for use in immunocompromised and elderly populations, although it may require multiple doses to achieve optimal immunogenicity [13].  

Vaccine Deployment Strategy <><>

While the licensing of these vaccines represents a major scientific milestone, their public health impact depends on their deployment in the real-world setting. Because CHIKV outbreaks are sporadic, geographically focal and difficult to predict, mass pre-emptive vaccination of entire populations is unlikely to be feasible or cost-effective for many countries. Instead, a vaccine stockpiling strategy may be adopted, whereby vaccines are rapidly deployed once an outbreak is detected [13]. The success of this approach relies heavily on early outbreak detection and rapid vaccine deployment. Delays in identifying viral circulation can allow transmission to accelerate beyond the point at which vaccination can meaningfully limit epidemic size. Consequently, there is a need for robust epidemiological surveillance systems capable of detecting CHIKV infections [14]. 

Diagnostic Challenges:  

Effective epidemiological surveillance is challenged by the clinical similarities between CHIKV and other arboviral diseases. These viruses not only share many of the same clinical symptoms but are also transmitted by the same species of mosquitoes, leading to frequent misdiagnosis and significant underreporting. As a consequence, CHIKV outbreaks often go unnoticed until the case numbers are substantial [15]. This emphasises a need for accurate, accessible and rapid diagnostic techniques, including molecular assays like quantitative reverse transcription-PCR and serological tests such as rapid test kits and ELISAs [16]. The Implementation of such diagnostic tests would not only enhance surveillance but also support vaccine deployment decisions, helping the authorities determine where and when vaccine campaigns are required [14]. 

Climate Change and Vector Expansion 

Climate change further complicates efforts to prevent CHIKV transmission. Urbanisation, rising temperatures and altered precipitation patterns are expanding the geographic range of Aedes mosquitoes into regions that were previously deemed unsuitable for habitation. Combined with increased international travel facilitating viral introduction to non-endemic areas, regions once considered low risk are becoming increasingly vulnerable to CHIKV outbreaks [17].  

This vector expansion places additional pressure on prevention strategies. Even if vaccination is successfully implemented in traditionally endemic locations, these efforts may prove insufficient when immunologically naïve populations are exposed [18] . Consequently, surveillance systems must extend beyond established viral hotspots to include surrounding and newly affected regions, enabling the early detection of viral transmission as vector distribution continues to shift. 

Conclusion

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References: 

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Written by Eleanor Crawley