Live-attenuated Chikungunya vaccine: a possible new era

Abstract

Chikungunya virus is a mosquito-borne pathogen that causes periodic explosive outbreaks of chikungunya, an illness characterised by severe polyarthralgia and myalgia that can progress to chronic debilitating rheumatic disease. 1 Bartholomeeusen K Daniel M LaBeaud DA et al. Chikungunya fever. Nat Rev Dis Primers. 2023; 9: 17 Crossref PubMed Scopus (0) Google Scholar The pandemic potential of chikungunya virus was best exemplified in 2013, when a major outbreak in South America led to over 1 million infections in a matter of months. 2 Zeller H Van Bortel W Sudre B Chikungunya: its history in Africa and Asia and its spread to new regions in 2013–2014. J Infect Dis. 2016; 214: S436-S440 Crossref PubMed Scopus (22) Google Scholar The pooled incidence of post-chikungunya chronic articular symptoms in the Americas was 52% in studies done between 2014 and 2018, 3 Edington F Varjão D Melo P Incidence of articular pain and arthritis after chikungunya fever in the Americas: a systematic review of the literature and meta-analysis. Joint Bone Spine. 2018; 85: 669-678 Crossref PubMed Scopus (19) Google Scholar leading to the loss of over 150 000 disability-adjusted life-years in Latin America in 2014 alone. 4 Cardona-Ospina JA Diaz-Quijano FA Rodríguez-Morales AJ Burden of chikungunya in Latin American countries: estimates of disability-adjusted life-years (DALY) lost in the 2014 epidemic. Int J Infect Dis. 2015; 38: 60-61 Summary Full Text Full Text PDF PubMed Scopus (27) Google Scholar In 2018, chikungunya virus was listed as a priority pathogen for vaccine development by WHO, 5 Mehand MS Al-Shorbaji F Millett P Murgue B The WHO R&D blueprint: 2018 review of emerging infectious diseases requiring urgent research and development efforts. Antiviral Res. 2018; 159: 63-67 Crossref PubMed Scopus (171) Google Scholar and candidate vaccines have been in various stages of clinical trials for over 60 years. However, no chikungunya virus vaccine has yet met the threshold for regulatory approval based on efficacy or surrogate marker data. Safety and immunogenicity of a single-shot live-attenuated chikungunya vaccine: a double-blind, multicentre, randomised, placebo-controlled, phase 3 trialThe strong immune response and the generation of seroprotective titres in almost all vaccinated participants suggests that VLA1553 is an excellent candidate for the prevention of disease caused by chikungunya virus. Full-Text PDF Open Access