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Do we need a vaccine against chikungunya?

Abstract During the last decade, the chikungunya (CHIKV) virus has expanded its range of activity, conquering new territories and becoming an important global health threat. In particular, the challenge represented by the recent emergence of CHIKV in the Americas has strengthened the need of a safe and effective vaccine. Although research on vaccines against CHIKV has been slow, a few vaccine candidates have been tested over the years. Inactivated and attenuated vaccine candidates have shown promising results in phase I/II trials, and engineered vaccines have proven to be safe and immunogenic in mouse and/or non-human primate models. Recently, a vaccine based on virus-like particles (VLP) has been successfully tested in a phase I trial. However, large phase I/II controlled trials, which are needed in order to provide evidence of vaccine efficacy, may be planned only under certain conditions. First, they should be conducted during epidemic periods, when a large number of cases occur, in order to ensure an adequate study power. Second, they are expensive and investments returns are not always guaranteed. To overcome this problem, public/private partnership and government support, the identification of target population groups for vaccination and the commitment of donor agencies are key factors for supporting both the development and the availability of vaccines against neglected tropical diseases like chikungunya.