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A live attenuated chikungunya vaccine, IXCHIQ, was approved in the United States in 2023 for use in adults. We assessed the cost-effectiveness of two different vaccination strategies, routine and outbreak vaccination, for persons aged ≥18 years living in U. S. territories with previous transmission. We included the entire population of impacted U. S. territories and assumed one chikungunya outbreak occurring during a 30-year time horizon. We estimated that routine vaccination would avert 90% of the disease burden and cost 498 million (16% savings compared with no vaccination) while outbreak vaccination would avert 67% of the disease burden and cost 552 million (6% savings). Both strategies were more costly than no vaccination from the healthcare payer perspective. Routine vaccination was cost-saving for all outcomes assessed from a societal perspective. Outbreak vaccination was cost-saving for averted symptomatic cases but cost from 5 95% CI: cost savings, 191 per chronic joint pain case averted to 373, 054 95% CI: 172, 643, 573, 464 per death averted.
Kilburn et al. (Mon,) studied this question.