Chikungunya virus: clinical use

Prescribing considerations

• Use only where there is a significant risk of chikungunya and after a comprehensive benefit–risk assessment by a professional experienced with live vaccines.
• Assess destination, outbreak status, travel pattern, occupational exposure, pregnancy and all underlying conditions.
• Exercise additional caution where two or more underlying health conditions are present.
• Arrange administration at least 30 days before travel and reinforce mosquito-bite avoidance.
• Do not administer concurrently with another vaccine; review recent or planned immunoglobulin and blood-product exposure.

Contraindications and cautions

• Age 60 years or older
• Hypersensitivity to the active component or an excipient
• Immunodeficiency or immunosuppression caused by disease or treatment
• IgA deficiency, thymus disorder or previous thymectomy
• Hypertension
• Cardiovascular disease
• Diabetes mellitus
• Chronic kidney disease

Monitoring

• Ensure anaphylaxis treatment is immediately available and observe after vaccination.
• Record the product name and batch number.
• Counsel about severe chikungunya-like and neurological reactions and when emergency assessment is required.
• Report suspected adverse reactions through the Yellow Card scheme.

Clinical pharmacology

A live attenuated ECSA/IOL-genotype chikungunya vaccine that elicits neutralising antibodies. Clinical protection was inferred from a serological surrogate endpoint rather than direct efficacy data; conventional pharmacokinetics are not applicable to vaccines.

Formulation and product differences

• The selected UK product is a powder with a separate sterile-water solvent and must be reconstituted before intramuscular administration.
• It contains genetically modified organisms and recombinant human albumin produced in yeast.
• Store refrigerated, protect from light and do not freeze; use promptly after reconstitution and discard if the permitted in-use period is exceeded.