Health-economic burden of chikungunya infection and potential cost-effectiveness of preventive vaccination in 31 countries

As the first chikungunya vaccines become available, estimates of their cost-effectiveness are needed. We developed a modelling framework to project the health-economic burden of chikungunya across 31 countries. We simulated several preventive vaccination campaigns and estimated threshold vaccination costs as the cumulative societal costs averted per vaccine dose. From 2025 to 2050, we projected a cumulative 5.96 million (5.10 million-6.93 million) DALYs and $76.5 billion ($57.4 billion-$95.7 billion) societal costs. A five-year population-wide campaign targeting 50% of individuals aged [≥]12 years, followed by a ten-year annual routine adolescent vaccination programme, averted 681,000 (569,000-802,000) DALYs and $11.8 billion ($8.73 billion-$14.9 billion) societal costs. Standalone population-wide campaigns were the most cost-effective, with threshold vaccination costs ranging from $1.11 ($0.77-$1.44) in the Democratic Republic of Congo to $48.1 ($36.0-$60.3) in Panama. Preventive deployment of a chikungunya vaccine with a favourable safety profile could substantially reduce the future burden of chikungunya across endemic settings.