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Vaccine Pregnancy: §4.6: there is a limited amount of data from the use of IXCHIQ in pregnant women, and these data are not sufficient to conclude on the absence of potential effects on pregnancy, embryo-foetal development, parturition and post-natal development; animal studies did not indicate direct or indirect harmful effects with respect to reproductive toxicity. Vertical transmission of wild-type CHIKV from pregnant individuals with viraemia at delivery is common and can cause potentially fatal CHIKV disease in neonates. Vaccine viraemia occurs in the first week following administration, with resolution by 14 days after vaccination; it is not known if the vaccine virus can be vertically transmitted and cause foetal or neonatal adverse reactions. Decisions to administer IXCHIQ during pregnancy should take into consideration the individual's risk of exposure to wild-type CHIKV, gestational age, and risks to the foetus or neonate from vertical transmission of wild-type CHIKV. Breast-feeding: it is unknown if IXCHIQ is excreted in human milk and a risk to the breastfed child cannot be excluded; weigh the developmental and health benefits of breastfeeding against the mother's clinical need and any potential adverse effects on the child.

Chikungunya vaccine (live attenuated)

Brand names: Ixchiq

This is a live attenuated vaccine used to provide active immunisation against chikungunya virus disease in eligible adults, typically travellers to endemic areas.

Adult dose

Dose: Prevention of disease due to chikungunya virus, in individuals at significant risk of acquiring chikungunya infection — individuals from 18-59 years of age: a single dose of 0.5 mL. The need for revaccination (booster dose) has not been established. AGE LIMIT: §4.4 states 'IXCHIQ must not be used in individuals 60 years and older'. TIMING: vaccination should be given no later than 30 days prior to travel.
Route: Intramuscular injection only, after reconstitution — administered in the deltoid muscle within 2 hours of reconstitution. The vaccine should not be mixed in the same syringe with any other vaccines or medicinal products. Vaccines must be administered by trained healthcare professionals with experience in benefit-risk evaluation of live vaccines.
Frequency: Single dose — the need for revaccination (booster dose) has not been established
BENEFIT-RISK GATE (§4.2 and §4.4): 'A comprehensive benefit risk assessment must be undertaken before offering IXCHIQ to any individuals', and IXCHIQ 'should only be given when there is a significant risk of acquiring chikungunya infection, and after careful consideration of the potential risks and benefits'. SERIOUS REACTIONS: serious adverse reactions have been reported, particularly in individuals aged 65 years and older and in individuals with two or more underlying chronic and/or uncontrolled medical conditions; severe reactogenicity or chikungunya-like adverse reactions may lead to deterioration of general condition including malaise and decreased appetite, exacerbation of pre-existing diseases, confusional state, encephalopathy or encephalitis, leading to falls, hospitalisation and death. Vaccinees should be instructed to seek medical attention promptly if such symptoms occur after vaccination. The 30-day pre-travel interval exists specifically to allow appropriate access to UK healthcare should adverse events occur. PAEDIATRIC (§4.2), verbatim: 'The safety and immunogenicity of IXCHIQ in children and adolescents aged 0 to 17 years have not yet been established. Only limited safety (see section 4.8) and immunogenicity data in adolescents 12 years of age and older are available.' No paediatric dose is stated, which is why paedDose is null. VACCINE VIRAEMIA AND SHEDDING: vaccine virus was demonstrated in blood and urine and might be present in other body fluids; viraemia was detected in 90% of subjects 3 days after vaccination, declined to 17% by 7 days, and no vaccine viraemia was detected 15 days after vaccination; a single participant shed vaccine virus in urine 7 days after vaccination. EFFECTIVENESS: the ability of IXCHIQ to prevent disease due to chikungunya virus was based on a serological surrogate endpoint, a protective immune response may not be elicited in all persons, and personal protection measures against mosquito bites should be continued after vaccination. §4.1 (therapeutic indications) was not fetched, and §4.4 and §4.8 were cut off at the source-fetch limit.

Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via the eMC — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Hypersensitivity to the active substance or to any of the excipients listed in section 6.1
  • Immunodeficient or immunosuppressed individuals due to disease or medical therapy — e.g. malignancies, chemotherapy, immunosuppressive therapy, congenital immunodeficiency, or HIV infection with severe immunosuppression
  • History of thymus disorder or thymectomy
  • IgA deficiency
  • Hypertension
  • Cardiovascular disease
  • Diabetes mellitus
  • Chronic kidney disease (CKD)
  • Individuals 60 years and older — stated in §4.4 rather than §4.3: 'IXCHIQ must not be used in individuals 60 years and older'
  • Note: the items from hypertension onwards are listed in §4.3 of the fetched SPC in a run-on sentence following the immunosuppression clause; they are reproduced here as separate contraindications as the SPC lists them

Side effects

  • Headache (32%) — very common
  • Fatigue (29.4%)
  • Myalgia (23.7%)
  • Arthralgia (16.6%)
  • Fever (13.8%)
  • Nausea (11.4%) — very common
  • Injection-site tenderness (10.8%) and injection-site pain (6.1%) — the most common vaccination site reactions
  • Lymphadenopathy (common); thrombocytopenia (uncommon)
  • Dizziness, paraesthesia, syncope (uncommon); confusional state (rare)
  • Encephalopathy, encephalitis, aseptic meningitis (frequency not known)
  • Eye pain, tinnitus, dyspnoea (uncommon); hypovolaemic hyponatraemia (rare)
  • Post-marketing serious adverse reactions, particularly in males aged 65 years and older with underlying chronic medical conditions such as cardiovascular disease, diabetes mellitus or chronic kidney disease — including neurological events such as fatal encephalitis, deterioration of general condition, and exacerbation of chronic medical conditions
  • Laboratory abnormalities (immunogenicity subset of 372 recipients): neutropenia (41.8%), leukopenia (31.2%), lymphopenia (22.3%), ALT increased (15.5%), AST increased (11.7%)
  • Note: the §4.8 adverse-reaction table was cut off at the source-fetch limit part-way through the gastrointestinal disorders row, so this list is not the complete set — consult the full SPC

Monitoring

  • Undertake a comprehensive benefit-risk assessment before offering IXCHIQ to any individual, and give it only where there is a significant risk of acquiring chikungunya infection
  • Do not use in individuals 60 years and older
  • Observe closely for at least 15 minutes following vaccination; appropriate medical treatment and supervision must be readily available in case of an anaphylactic event
  • Instruct vaccinees to seek medical attention promptly if, after vaccination, they experience symptoms suggestive of severe reactogenicity or severe chikungunya-like adverse reactions
  • Vaccinate no later than 30 days before travel, to allow appropriate access to UK healthcare
  • Record the name and batch number of the administered product, to improve traceability of biological medicinal products
  • Postpone vaccination in individuals suffering from acute severe febrile illness or acute infection; a minor infection and/or low-grade fever should not delay vaccination
  • Use caution in individuals receiving anticoagulant therapy and in those with thrombocytopenia or any coagulation disorder (such as haemophilia), because bleeding or bruising may occur after intramuscular injection
  • Put precautions in place to avoid injury from fainting — anxiety-related reactions including vasovagal reactions (syncope), hyperventilation and stress-related reactions may occur
  • Advise continued personal protection measures against mosquito bites after vaccination — a protective immune response may not be elicited in all persons

Clinical monograph

How it works

It contains a live attenuated chikungunya virus strain that stimulates the immune system to produce protective neutralising antibodies against the virus.

Prescribing in practice

  • As a live vaccine it is contraindicated in significantly immunocompromised individuals and requires caution in pregnancy, with use guided by MHRA and current immunisation advice.
  • Following MHRA and UK safety review, use in older adults has been approached cautiously pending evaluation of serious adverse events in that group.
  • Assess suitability against the current chikungunya vaccination recommendations and the individual's travel risk before administering.

Monitoring

Observe the patient after vaccination for immediate hypersensitivity and counsel on delayed reactions, reporting suspected adverse effects via the Yellow Card scheme.

Counselling the patient

  • This vaccine helps protect against chikungunya, a mosquito-borne viral illness.
  • Continue mosquito-bite precautions when travelling, as no vaccine is fully protective.
  • Report any severe or persistent reaction after vaccination.

Evidence & guidelines

Use is governed by MHRA licensing and current UK travel immunisation guidance, which is periodically updated as safety data accumulate.

Reference: UK Green Book; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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