Chikungunya Vaccine

One formulation vaccine contains a live-attenuated viral component.

Another formulation is a recombinant viral vaccine consisting of purified virus-like particles (VLPs) and capsid and envelope proteins. 

Both vaccines provide protection against the chikungunya virus.

The chikungunya vaccine is indicated for the prevention of disease caused by chikungunya virus in people ≥ 18 years of age who are at increased risk of exposure to the chikungunya virus.The chikungunya vaccine is indicated for the prevention of disease caused by chikungunya virus in people ≥ 18 years of age who are at increased risk of exposure to the chikungunya virus.

The Advisory Committee on Immunization Practices (ACIP) recommends the chikungunya vaccine for adults aged ≥ 18 years traveling to a country or territory where there is a chikungunya outbreak (The Advisory Committee on Immunization Practices (ACIP) recommends the chikungunya vaccine for adults aged ≥ 18 years traveling to a country or territory where there is a chikungunya outbreak (1). In addition, the chikungunya vaccine may be considered for the following people traveling to a country or territory without an outbreak but with evidence of chikungunya virus transmission among humans within the last 5 years:

• Recombinant vaccine only: People aged > 65 years, particularly those with underlying medical conditions, who are likely to have at least moderate exposure to mosquitoes (moderate exposure could include travelers who might have at least 2 cumulative weeks of exposure to mosquitoes in indoor or outdoor settings)

• People staying in such an area for a cumulative period of 6 months or more

ACIP also recommends chikungunya vaccine for laboratory workers with potential for exposure to the chikungunya virus.ACIP also recommends chikungunya vaccine for laboratory workers with potential for exposure to the chikungunya virus.

The main contraindications for the chikungunya vaccinemain contraindications for the chikungunya vaccine are the following:

• Immunodeficiency or immunosuppression due to disease (eg, resulting from hematologic and solid tumors or congenital immunodeficiency, patients with HIV infection who are severely immunocompromised) or medical therapy (eg, chemotherapy, long-term immunosuppressive therapy)

• History of severe allergic reaction (eg, anaphylaxis) to any component of the vaccine

• The live-attenuated vaccine should not be used among people ≥ 60 years until reports of cardiac adverse events undergo further investigation.

Precautions for the chikungunya vaccinePrecautions for the chikungunya vaccine include the following:

• Appropriate medical treatment and supervision must be available in the event anaphylaxis occurs.

• The vaccine may cause severe or prolonged chikungunya-like adverse reactions.

• Vaccine viremia occurs in the first week after administration of the vaccine. It is not known if the vaccine virus can be transmitted from a pregnant patient to the fetus or neonate and cause fetal or neonatal adverse reactions. However, vertical transmission of wild-type chikungunya virus to neonates from pregnant patients with viremia at delivery is common and can cause severe, potentially fatal chikungunya disease in neonates. Therefore, vaccination in pregnant patients is recommended to be postponed until after delivery. However, if exposure to the virus is unavoidable, shared decision making to administer the vaccine during pregnancy should take into consideration the patient's risk of exposure to the wild-type virus, gestational age of the fetus, and risks to the fetus or neonate from vertical transmission of wild-type virus (1).

• In the absence of data, breastfeeding (chestfeeding) is a precaution for vaccination. However, if the risk of chikungunya virus infection is high, such as during an outbreak, vaccination may be administered, but clinicians should discuss with breastfeeding patients the benefits of breastfeeding for the infant versus the risks associated with chikungunya infection (2).

• Syncope (fainting) can occur in association with administration of injectable vaccines including the chikungunya vaccine. Procedures should be in place to avoid injury from fainting.

The chikungunya vaccine dose is 0.5 mL IM. The chikungunya vaccine dose is 0.5 mL IM.

The live lyophilized antigen component is reconstituted at the time of use with the accompanying sterile water.

The most commonly reported adverse effects include the following:

• Injection site reaction and tenderness

• Headache

• Fatigue

• Myalgia

• Arthralgia

• Fever

• Nausea

For more information about adverse effects of these vaccines, refer to the prescribing information.

The following English-language resource may be useful. Please note that The Manual is not responsible for the content of this resource.

1. Advisory Committee on Immunization Practices (ACIP): ACIP Recommendations