IXCHIQ Chikungunya vaccine: updates to restrictions of use following safety review
Following the completion of a safety review and the recommendations of the Commission on Human Medicines (CHM), the IXCHIQ Chikungunya vaccine is no longer indicated for adults over the age of 60 years, and is contraindicated in all individuals with hypertension, cardiovascular disease, diabetes mellitus, and/or chronic kidney disease.
Summary
Following the completion of a safety review and the recommendations of the Commission on Human Medicines (CHM), the IXCHIQ Chikungunya vaccine is no longer indicated for adults over the age of 60 years, and is contraindicated in all individuals with hypertension, cardiovascular disease, diabetes mellitus, and/or chronic kidney disease. This action follows very rare fatal reactions, and other serious adverse reactions reported globally last year. In addition, the CHM have advised that the IXCHIQ vaccine should be given no later than 30 days prior to travel.
Advice for Healthcare Professionals:
- Chikungunya vaccine (IXCHIQ) is a vaccine to protect against severe Chikungunya virus infection; strict adherence to contraindications and precautions is essential to reduce the risk of very rare but potentially fatal adverse reactions
- a live attenuated Chikungunya vaccine, IXCHIQ, first became available on the UK market on 18 June 2025
- IXCHIQ vaccine is already contraindicated in all individuals with immunodeficiency or immunosuppression as a result of disease or medical therapy, this includes IgA deficiency, history of thymus disorder or thymectomy
- following a review of the benefits and risks of the vaccine, the CHM has the following further recommendations:
- do not use this vaccine in adults aged 60 years or over, or in individuals with hypertension, cardiovascular disease, diabetes mellitus, and/or chronic kidney disease
- the vaccine should be given no later than 30 days prior to travel
- in addition, a comprehensive benefit risk assessment must be conducted prior to vaccination by a healthcare professional trained in the benefit risk assessment of live vaccines
- precaution is advised when considering vaccination in individuals with two or more underlying health conditions
- the product information for the vaccine will be updated to reflect these changes, and a letter for healthcare professionals will be circulated from the company in addition to this Drug Safety Update, to advise of the above-mentioned restrictions
- patients who have received the vaccine should be advised to seek emergency medical attention if they develop signs or symptoms associated with viraemia, including arthralgia, or neurological symptoms which may indicate encephalitis
- all patients who have received the vaccine should receive the manufacturer’s Patient Information Leaflet as part of the travel consultation
- report suspected adverse reactions associated with the IXCHIQ vaccine on a Yellow Card
Advice for Healthcare Professionals to Provide to Patients:
- the Chikungunya vaccine is for adults who plan to travel abroad to regions where Chikungunya virus is present. Chikungunya virus is a potentially life-threatening viral infection
- a live attenuated Chikungunya vaccine, IXCHIQ, first became available on the UK market on 18 June 2025
- you will not be given this vaccine if you are aged 60 years or over, or if you have hypertension, cardiovascular disease, diabetes mellitus, and/or chronic kidney disease, or if you are immunosuppressed or immunodeficient. This is because there have been rare reports of serious side effects in individuals aged 60 and above, and/or in individuals with the chronic conditions specified above. An alternative vaccine is available if IXCHIQ vaccination is unsuitable for you
- during your vaccine consultation you will be assessed by a healthcare professional for vaccine suitability, and the risks and benefits of having the vaccine will also be discussed with you
- if you have received a Chikungunya vaccine, you should seek urgent medical attention if you start to experience signs or symptoms associated with serious reactions resembling chikungunya infection, including arthralgia (severe joint pain), or neurological symptoms including encephalopathy (stiff neck, fever, confusion, memory loss, personality changes or loss of consciousness)
Background
Following global reports of serious adverse events in older people, and individuals with underlying chronic conditions, the Commission on Human Medicines (CHM) has recommended that IXCHIQ Chikungunya vaccine should not be used in adults aged 60 years and over. The vaccine remains contraindicated for all immunosuppressed and immunodeficient individuals, with IgA deficiency and history of thymus disorder or thymectomy added to the list of example immunodeficiencies. In addition, the vaccine is now contraindicated in individuals with hypertension, cardiovascular disease, diabetes mellitus, and/or chronic kidney disease.
Further recommendations include conducting a comprehensive benefit risk assessment prior to vaccination, with caution advised when vaccinating individuals who have two or more underlying health conditions. The benefit risk assessment and vaccine administration should only be conducted by healthcare professions with training and experience of risk assessments for live vaccines.
Finally, the vaccine should be given no later than 30 days prior to travel to ensure that if any serious adverse reactions occur, the individual is still in the UK with appropriate access to healthcare, and there are no language barriers.
About the IXCHIQ Chikungunya Vaccine
Chikungunya virus is a potentially life-threatening viral infection and protective measures against the disease are essential for anyone travelling to an area where there is a risk of infection.
Chikungunya virus is found in the subtropical regions of the Americas, Africa, Southeast Asia, India, and the Pacific Region, and is most commonly spread to humans by the bite of an infected mosquito (Aedes aegypti and Aedes albopictus). The virus cannot be passed from person-to-person through casual contact, such as coughing, sneezing or touching.
For most people, the balance between the benefits and possible side effects of the IXCHIQ vaccine remains favourable. However, because the IXCHIQ vaccine contains a live, weakened strain of the Chikungunya virus, strict adherence to contraindications and precautions is essential to reduce the risk of serious side effects in those who may have a weaker immune system.
Serious side effects that resemble Chikungunya infection are very rare but can be fatal, these include rare neurological side effects including encephalitis. These risks are more likely to occur in certain groups, particularly people with a weakened immune system.
At vaccination, all vaccinees should receive the manufacturer’s Patient Information Leaflet for IXCHIQ vaccine, which advises them on symptoms to be vigilant for following vaccination.
Reporting advice
Healthcare professionals, patients, and caregivers are asked to submit reports using the Yellow Card scheme electronically using:
- the Yellow Card website
- the Yellow Card app; download from the Apple App Store or Google Play Store
- some clinical IT systems for healthcare professionals (EMIS, SystmOne, Vision, MiDatabank, and Ulysses)
When reporting suspected adverse drug reactions, please provide as much information as possible, including information about medical history, any concomitant medication, onset timing, and treatment dates.
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Additional information
For further information see: National Travel Health Network and Centre website
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Article citation: MHRA Drug Safety Update volume 19, issue 7: February 2026: 2