Chikungunya Vaccine

The chikungunya vaccine is a live-attenuated recombinant viral vaccine. It provides protection against the chikungunya virus, an alphavirus in the Togavirus family.

The chikungunya vaccine is indicated for the prevention of disease caused by chikungunya virus in individuals ≥ 18 years of age who are at increased risk of exposure. In February 2024, theAdvisory Committee on Immunization Practices (ACIP) approved recommendations for use of the vaccine among certain people who travel abroad and for laboratory workers in the United States.

ACIP recommends chikungunya vaccine for adults aged ≥ 18 years traveling to a country or territory where there is a chikungunya outbreak. In addition, 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:

• 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) OR

• 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 chikungunya virus.

The main contraindications for the chikungunya vaccine are

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

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

Precautions for the chikungunya vaccine are

• 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 following administration of the vaccine. It is not known if the vaccine virus can be transmitted from a pregnant individual to the fetus or neonate and cause fetal or neonatal adverse reactions. However, vertical transmission of wild-type chikungunya virus to neonates from pregnant individuals with viremia at delivery is common and can cause severe, potentially fatal chikungunya disease in neonates.

• 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.

• Vaccination with the chikungunya vaccine may not protect all individuals.

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 common adverse effects reported in clinical studies were

• Injection site reaction and tenderness

• Headache

• Fatigue

• Myalgia

• Arthralgia

• Fever

• Nausea

The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

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

2. U.S. Food and Drug Administration (FDA): Chikungunya Vaccine, Live approved prescribing information