Strategic considerations on developing a CHIKV vaccine and ensuring equitable access for countries in need

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Abstract

Chikungunya is an arboviral disease caused by the chikungunya virus (CHIKV) afflicting tropical and sub-tropical countries worldwide. It has been identified as a priority pathogen by the Coalition for Epidemics Preparedness Innovations (CEPI) and as an emerging infectious disease (EID) necessitating further action as soon as possible by the World Health Organization (WHO). Recent studies suggest that disability-adjusted life years (DALYs) due to CHIKV infection are as high as 106,089 DALYs lost globally. Significant progress has been made in the development of several vaccines, aimed at preventing CHIKV infections. This perspective article summarizes CEPI’s efforts and strategic considerations for developing a CHIKV vaccine and ensuring equitable access for CHIKV endemic countries.

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A VLP vaccine for epidemic Chikungunya virus protects non-human primates against infection

Wataru Akahata, Zhi-yong Yang, Hanne Andersen … (2010)

Chikungunya virus (CHIKV) has infected millions of people in Africa, Europe, and Asia1,2 since its re-emergence in Kenya in 2004. The severity of disease and spread of this epidemic virus present a serious public health threat in the absence of vaccines or anti-viral therapies. Here, we describe a novel vaccine that protects against emerging CHIKV infection of non-human primates (NHP). We show that selective expression of viral structural proteins gives rise to virus-like particles (VLPs) in vitro that resemble replication-competent alphaviruses. Immunization with these VLPs elicited neutralizing antibodies against envelope proteins from different CHIKV strains. Monkeys immunized with VLPs produced high titer neutralizing antibodies that protected against viremia after high dose challenge. We transferred these antibodies into immunodeficient mice, where they protected against subsequent lethal CHIKV challenge, establishing a humoral mechanism of protection. Immunization with alphavirus VLP vaccines represents a strategy to contain the spread of CHIKV and related pathogenic viruses in humans.

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Local and regional spread of chikungunya fever in the Americas.

S Cauchemez, M Ledrans, C Poletto … (2014)

Chikungunya fever (CHIKV), a viral disease transmitted by mosquitoes, is currently affecting several areas in the Caribbean. The vector is found in the Americas from southern Florida to Brazil, and the Caribbean is a highly connected region in terms of population movements. There is therefore a significant risk for the epidemic to quickly expand to a wide area in the Americas. Here, we describe the spread of CHIKV in the first three areas to report cases and between areas in the region. Local transmission of CHIKV in the Caribbean is very effective, the mean number of cases generated by a human case ranging from two to four. There is a strong spatial signature in the regional epidemic, with the risk of transmission between areas estimated to be inversely proportional to the distance rather than driven by air transportation. So far, this simple distance-based model has successfully predicted observed patterns of spread. The spatial structure allows ranking areas according to their risk of invasion. This characterisation may help national and international agencies to optimise resource allocation for monitoring and control and encourage areas with elevated risks to act.

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The global epidemiology of chikungunya from 1999 to 2020: A systematic literature review to inform the development and introduction of vaccines

Alison A. Bettis, Maïna L’Azou Jackson, In-Kyu Yoon … (2022)

Chikungunya fever is an acute febrile illness that is often associated with severe polyarthralgia in humans. The disease is caused by chikungunya virus (CHIKV), a mosquito-borne alphavirus. Since its reemergence in 2004, the virus has spread throughout the tropical world and several subtropical areas affecting millions of people to become a global public health issue. Given the significant disease burden, there is a need for medical countermeasures and several vaccine candidates are in clinical development. To characterize the global epidemiology of chikungunya and inform vaccine development, we undertook a systematic literature review in MEDLINE and additional public domain sources published up to June 13, 2020 and assessed epidemiological trends from 1999 to 2020. Observational studies addressing CHIKV epidemiology were included and studies not reporting primary data were excluded. Only descriptive analyses were conducted. Of 3,883 relevant sources identified, 371 were eligible for inclusion. 46% of the included studies were published after 2016. Ninety-seven outbreak reports from 45 countries and 50 seroprevalence studies from 31 countries were retrieved, including from Africa, Asia, Oceania, the Americas, and Europe. Several countries reported multiple outbreaks, but these were sporadic and unpredictable. Substantial gaps in epidemiological knowledge were identified, specifically granular data on disease incidence and age-specific infection rates. The retrieved studies revealed a diversity of methodologies and study designs, reflecting a lack of standardized procedures used to characterize this disease. Nevertheless, available epidemiological data emphasized the challenges to conduct vaccine efficacy trials due to disease unpredictability. A better understanding of chikungunya disease dynamics with appropriate granularity and better insights into the duration of long-term population immunity is critical to assist in the planning and success of vaccine development efforts pre and post licensure.

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Author and article information

Contributors

Neil Cherian:

ORCID: http://orcid.org/0000-0001-5346-3111

neil.cherian@cepi.net

Journal

Journal ID (nlm-ta): NPJ Vaccines

Journal ID (iso-abbrev): NPJ Vaccines

Title: NPJ Vaccines

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2059-0105

Publication date (Electronic): 18 August 2023

Publication date PMC-release: 18 August 2023

Publication date Collection: 2023

Volume: 8

Electronic Location Identifier: 123

Affiliations

Coalition for Epidemics Preparedness Innovations, Oslo, Norway

Author information

Neil Cherian http://orcid.org/0000-0001-5346-3111

Arun Kumar http://orcid.org/0000-0003-4483-7585

Jose Luis Di Fabio http://orcid.org/0000-0002-1187-7110

Amol Chaudhari http://orcid.org/0000-0001-9972-9755

Article

Publisher ID: 722

DOI: 10.1038/s41541-023-00722-x

PMC ID: 10439111

PubMed ID: 37596253

SO-VID: 96a80ba4-0e26-4aca-90ca-8b9004859550

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 4 April 2023

Date accepted : 3 August 2023

Funding

Funded by: Coalition for Epidemics Preparedness Innovations

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Keywords: infectious diseases,drug development

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Keywords: infectious diseases, drug development

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Strategic considerations on developing a CHIKV vaccine and ensuring equitable access for countries in need

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Most cited references 16

A VLP vaccine for epidemic Chikungunya virus protects non-human primates against infection

Local and regional spread of chikungunya fever in the Americas.

The global epidemiology of chikungunya from 1999 to 2020: A systematic literature review to inform the development and introduction of vaccines

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