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National Center for Emerging and Zoonotic Infectious Diseases
PROPOSED POLICY OPTIONS FOR 
CHIKUNGUNYA VACCINE USE AMONG 
U.S. LABORATORY WORKERS
Susan Hills, MBBS, MTH
CDC Lead , Chikungunya Vaccines Work Group
Arboviral Diseases Branch
Division of Vector -Borne Diseases
Fort Collins, Colorado
   ACIP meeting, February 28, 2024
Chikungunya virus infections among laboratory workers
At least 44 infections identified among laboratory workers worldwide over 
~ 50 years1–3 
–43 cases overt disease, 1 asymptomatic infection, no deaths
4 disease cases in U.S. laboratorians since chikungunya became notifiable disease in 2015
–Similar symptoms as with infection acquired via mosquito -borne route
–One case hospitalized for observation, no deaths 
Identified cases underestimate all infections as no formal laboratory surveillance system
1.The Subcommittee on Arbovirus Laboratory Safety of the American Committee on Arthropod -Borne Viruses. Am J Trop Med Hyg 1980;
2.Rusnak JM, et al. J Occup Environ Med 2004; 3. US national arboviral disease surveillance system, 2015 –2022 
Routes of laboratory transmission
Aerosol 
Percutaneous
–Needlestick while working with and 
injecting mice
–Forceps prick while dissecting mosquitoes infected with chikungunya virus
Mucosal (possible)

Factors for consideration
Vaccination required for only limited number of staff who might be 
exposed to live chikungunya virus
–Vaccination not necessary for workers handling routine clinical samples 
–Recommendations only for laboratorians undertaking research or very 
specific diagnostic work using live virus (e.g., plaque reduction 
neutralization tests)
Work group summary
–Benefits of vaccination outweigh risks for small group of laboratorians 
working with live virus, given potential for acquiring chikungunya virus 
infection which can result in severe polyarthralgia and possibly chronic 
arthralgia 
Draft recommendation 
Chikungunya vaccination is recommended for laboratory 
workers with potential for exposure to chikungunya virus.
Information accompanying recommendations
Local biosafety committee should undertake risk assessment 
of potential for chikungunya virus exposure considering 
–Type of work to be performed 
–Biosafety level at which work is being conducted
Vaccination not necessary for workers handling routine clinical samples 
Draft recommendation 
Chikungunya vaccination is recommended for laboratory 
workers with potential for exposure to chikungunya virus.