Mem Inst Oswaldo Cruz, Rio de Janeiro, VOLUME 121 | 2026
Perspective

Chikungunya vaccine approval in Brazil: navigating through epidemiological challenges and immunisation strategies

Claudia Renata dos Santos Barros, Sandra Coccuzzo Sampaio, Maria Carolina Elias, Svetoslav Nanev Slavov+

Instituto Butantan, Centro de Vigilância Viral e Avaliação Sorológica, São Paulo, SP, Brasil

DOI: 10.1590/0074-02760260088
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ABSTRACT

Chikungunya virus (CHIKV) can cause acute arboviral illness, usually accompanied by severe polyarthralgia. In 2025, live-attenuated CHIKV vaccine Ixchiq® (Valneva, Saint-Herblain, France) was authorised for use in Brazil, where CHIKV often co-circulates with other arboviruses. A central public health question emerges: how should this vaccine be optimally deployed in a country characterised by hyperendemic transmission, frequent underdiagnosis, and marked regional disparities? We conducted an epidemiological analysis using notified CHIKV cases from the Notifiable Diseases Information System (SINAN) and socioeconomic indicators from the Brazilian Human Development Atlas. This framework enabled the identification of municipal clusters with shared epidemiological and socioeconomic profiles, allowing exploration of the relationship between disease notification rate and social health determinants. Our results showed that CHIKV transmission exhibited a cyclic pattern with geographic expansion toward the Southeast/South — Brazil’s most densely populated regions characterised by low population immunity. Cluster analyses showed that the greatest disease burden is concentrated in socioeconomically disadvantaged municipalities, particularly in the Northeast, where healthcare disparities may further impact diagnostic capacity. Based on the obtained results, we believe in a hybrid immunisation strategy starting from high-incidence municipalities in the northeast and reaching major urban centres in the southeast in order to prevent larger outbreaks. Implementation must account also for current vaccine contraindications in high-risk groups and be guided by real-time epidemiological and entomological surveillance.

key words: Chikungunya virus arboviruses vaccine spatial epidemiology health inequities Brazil
REFERENCES
01. da Cunha RV, Trinta KS. Chikungunya virus: clinical aspects and treatment - A Review. Mem Inst Oswaldo Cruz. 2017; 112(8): 523- 31. doi: 10.1590/0074-02760170044.
02. Bartholomeeusen K, Daniel M, LaBeaud DA, Gasque P, Peeling RW, Stephenson KE, et al. Chikungunya fever. Nat Rev Dis Primers. 2023; 9(1): 17. doi: 10.1038/s41572-023-00429-2.
03. Higgs S, Vanlandingham D. Chikungunya virus and its mosquito vectors. Vector Borne Zoonotic Dis. 2015; 15(4): 231-40. doi: 10.1089/vbz.2014.1745.
04. Wahid B, Ali A, Rafique S, Idrees M. Global expansion of Chikungunya virus: mapping the 64-year history. Int J Infect Dis. 2017; 58: 69-76. doi: 10.1016/j.ijid.2017.03.006.
05. Nunes MR, Faria NR, de Vasconcelos JM, Golding N, Kraemer MU, de Oliveira LF, et al. Emergence and potential for spread of Chikungunya virus in Brazil. BMC Med. 2015; 13: 102. doi: 10.1186/s12916-015-0348-x.
06. de Almeida IF, Codeço CT, Lana RM, Bastos LS, Oliveira SS, Ferreira DAC, et al. The expansion of chikungunya in Brazil. Lancet Reg Health Am. 2023; 25: 100571. doi: 10.1016/j.lana.2023.100571.
07. Maure C, Khazhidinov K, Kang H, Auzenbergs M, Moyersoen P, Abbas K, et al. Chikungunya vaccine development, challenges, and pathway toward public health impact. Vaccine. 2024; 42(26): 126483. doi: 10.1016/j.vaccine.2024.126483.
08. Sallas J, Elidio GA, Costacurta GF, Frank CHM, Rohlfs DB, Pacheco FC, et al. Decrease in compulsory notifications registered by the Brazilian National Hospital Epidemiological Surveillance Network during the COVID-19 pandemic: a descriptive study, 2017-2020. Epidemiol Serv Saude. 2022; 31(1): e2021303. doi: 10.1590/S1679-49742022000100011.
09. Freitas ARR, Chagas AAP, Siqueira AM, Cavalcanti LPG. How much of the current serious arbovirus epidemic in Brazil is dengue and how much is chikungunya? Lancet Reg Health Am. 2024; 34: 100753. doi: 10.1016/j.lana.2024.100753.
10. de Souza WM, Ribeiro GS, de Lima STS, de Jesus R, Moreira FRR, Whittaker C, et al. Chikungunya: a decade of burden in the Americas. Lancet Reg Health Am. 2024; 30: 100673. doi: 10.1016/j.lana.2023.100673.
11. Gregianini TS, Salvato RS, Barcellos RB, Godinho FM, Ruivo AP, de Melo VH, et al. Chikungunya virus infection in the southernmost state of Brazil was characterised by self-limited transmission (2017-2019) and a larger 2021 outbreak. Mem Inst Oswaldo Cruz. 2023; 118: e220259. doi: 10.1590/0074-02760220259.
12. Mordecai EA, Cohen JM, Evans MV, Gudapati P, Johnson LR, Lippi CA, et al. Detecting the impact of temperature on transmission of Zika, dengue, and chikungunya using mechanistic models. PLoS Negl Trop Dis. 2017; 11(4): e0005568. doi: 10.1371/journal. pntd.0005568.
13. Power GM, Vaughan AM, Qiao L, Clemente NS, Pescarini JM, Paixão ES, et al. Socioeconomic risk markers of arthropodborne virus (arbovirus) infections: a systematic literature review and meta-analysis. BMJ Glob Health. 2022; 7(4): e 007735. doi: 10.1136/bmjgh-2021-007735.
14. Martoreli Jr JF, Ramos ACV, Alves JD, Berra TZ, Alves YM, Tavares RBV, et al. Measuring social vulnerability in communities and its association with leprosy burden through spatial intelligence in central West Brazil to guide strategic actions. Arch Public Health. 2024; 82(1): 246. doi: 10.1186/s13690-024-01484-1.
15. Kulldorff M. Prospective time periodic geographical disease surveillance using a scan statistic. J Royal Stat Soc: Series A (Statistics in Society). 2001; 164: 61-72. doi: https://doi. org/10.1111/1467-985X.00186.
16. Teixeira MG, Skalinski LM, Paixão ES, Costa MDCN, Barreto FR, Campos GS, et al. Seroprevalence of Chikungunya virus and living conditions in Feira de Santana, Bahia-Brazil. PLoS Negl Trop Dis. 2021; 15(4): e0009289. doi: 10.1371/journal.pntd.0009289.
17. Braga C, Martelli CMT, Souza WV, Luna CF, Albuquerque MFPM, Mariz CA, et al. Seroprevalence of Dengue, Chikungunya and Zika at the epicenter of the congenital microcephaly epidemic in Northeast Brazil: a population-based survey. PLoS Negl Trop Dis. 2023; 17(7): e0011270. doi: 10.1371/journal.pntd.0011270.
18. Slavov SN, Otaguiri KK, Bianquini ML, Bitencourt HTO, Chagas MCM, Guerreiro DSS, et al. Seroprevalence of Chikungunya virus in blood donors from Northern and Southeastern Brazil. Hematol Transfus Cell Ther. 2018; 40(4): 358-62. doi: 10.1016/j. htct.2018.04.002.

Financial support: FAPESP (Grant Numbers 2021/11944-6 and 2017/23205-8), CNPq (grant number 403075/2023-8), the Butantan Foundation. SNS receives a productivity scholarship (PQ) from CNPq (number 305111/2022-1), MCE receives grant number 31125/2021 from CNPq.
+ Corresponding author: svetoslav.slavov@fundacaobutantan.org.br | ORCID https://orcid.org/0000-0003-0805-6140
Received 16 March 2026
Accepted 29 May 2026

HOW TO CITE
Barros CRS, Sampaio SC, Elias MC, Slavov SN. Chikungunya vaccine approval in Brazil: navigating through epidemiological challenges and immunisation strategies. Mem Inst Oswaldo Cruz. 2026; 121: e260088.

HANDLING EDITOR
Mariza Morgado | ORCID https://orcid.org/0000-0002-9304-6184

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