LAUSR

Background/Objectives: As of April 2025, La Réunion is facing a second major chikungunya virus (CHIKV) outbreak, following the 2005–2006 epidemic that infected nearly one-third of the population. IXCHIQ®, a live-attenuated, single-dose vaccine, offers an opportunity for targeted immunization to complement vector control efforts. Using surveillance data up to 23 February 2025 (week 7), we estimated the potential scale of the 2024–2025 chikungunya outbreak in La Réunion and how much of the burden could have been averted by an emergency vaccination campaign at different detection thresholds. Methods: A stochastic SEIR–SEI host–vector model was calibrated to weekly case counts (weeks 46/2024–7/2025). We projected the epidemic under three vaccination-trigger scenarios (≥100, ≥3000, ≥40,000 detected cases) and two incremental vector-control assumptions (10% and 20% reductions in biting rate). Several mosquito-related parameters—extrinsic incubation period, offspring number, and mortality rate—were temperature-dependent, based on daily temperatures in La Réunion. Vaccination was applied homogeneously, using a 14.5% coverage to reflect the proportion of the population targeted in the initial public health recommendation. Results: Our findings indicate that without vaccination, up to 27.5% of the population could become infected. If vaccination would begin after 100 detected cases, 75% of infections could be prevented. Delaying until 3000 or 40,000 cases reduced effectiveness to 41% and 11%, respectively. Conclusions: Our results show that timely emergency vaccination can substantially reduce outbreak size. This underscores the importance of preparedness and rapid response by public health authorities in high-risk regions.