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Chikungunya vaccine: Canadian Immunization Guide

For health professionals

New chapter: February 2026

This new chapter was developed based on the following statement from the Committee to Advise on Tropical Medicine and Travel (CATMAT):

This information is captured in the table of updates.

On this page

Please note: The Public Health Agency of Canada (PHAC) recognizes that not all people giving birth or breastfeeding will identify as women or mothers. The writing in this chapter uses a gender additive approach where the term 'woman' is used alongside gender neutral language. This is intended to demonstrate a commitment to redress the historic exclusion of trans and non-binary people, whilst avoiding the risk of marginalising or erasing the experience of women within the health care environment. However, in line with best practice, it is recognized that when discussing or caring for individuals in a one-on-one capacity, language and documentation should reflect the gender identity of the individual. Finally, PHAC acknowledges the dynamic nature of language. It is likely that language deemed to be suitable or affirming in one context may not translate across others, and over the coming years will likely change and evolve with respect to appropriate representations.

Epidemiology

Disease description

Infectious agent

Chikungunya virus (CHIKV) is a positive-sense, single-stranded ribonucleic acid virus in the alphavirus genus of the family Togaviridae.

For additional information on CHIKV, refer to the Pathogen Safety Data Sheet.

Reservoir

Non-human primates (NHPs), rodents, bats, and possibly birds.

Transmission

Chikungunya virus (CHIKV) is primarily transmitted to humans through the bite of infected Aedes (Stegomyia) mosquitoes, predominantly Aedes aegypti and Aedes albopictus, which are not established in Canada. These mosquito species are also vectors for other arboviruses, including dengue and zika viruses. Severe neonatal cases resulting in neurological disease or neonatal sepsis have been reported following vertical transmission, as well as infection in laboratory workers due to accidental exposure. The incubation period is usually 3 to 7 days, with a range of 2 to 12 days.

Risk factors

Risk of infection with CHIKV depends on the individual's exposure to infected vectors, which is influenced by environmental conditions, season, living conditions and individual behaviours (e.g., use of mosquito repellents). Infection is thought to result in long-term immunity, so some people in endemic or outbreak areas may not be susceptible. Groups at higher risk of severe disease include neonates, older adults, and those with underlying medical conditions. Diabetes, hypertension, cardiac disease, and/or pre-existing joint disease are some of the medical conditions that are believed to increase the likelihood of developing serious chikungunya disease.

Spectrum of clinical illness

Chikungunya disease is characterized by the sudden onset of fever accompanied by joint pain that is debilitating for some and could last for months or even years following infection. Other symptoms include joint swelling, muscle pain, headache, nausea, fatigue, and rash mainly affecting the trunk and limbs. In healthy persons, chikungunya associated deaths are rare, though risk increases substantially in older persons especially those with medical conditions. Severe neurological complications, myocarditis, and nephritis have also been reported primarily in older adults, those with immunocompromising conditions, and newborns.

Currently, there is no specific antiviral treatment for chikungunya virus infection. Clinical management is primarily supportive and focuses on relief of symptoms of fever and joint pain through the use of antipyretics and analgesics. Non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided until dengue is ruled out due to the increased risk of bleeding.

Disease distribution

Incidence and prevalence

Global

CHIKV was first identified in the United Republic of Tanzania in 1952 and is endemic throughout much of the tropical and sub-tropical world, with cases reported across the Americas, Asia, Africa, and Europe. Many tropical regions are presumed to sustain low but persistent levels of chikungunya transmission; however, this endemic activity can escalate into large outbreaks affecting a large proportion of the local population and consequently increasing the risk to travellers to these regions. Outbreaks are often of short duration, lasting for 3 to 6 months, after which transmission and reported number of infections and cases decline.

Refer to Travel advice and advisories by destination for information on travel-health related risks, including the risk of chikungunya by destination.

National

Chikungunya is not currently endemic in Canada. However, there are reports of imported cases among travellers returning from areas where there is sustained transmission of CHIKV, particularly areas experiencing outbreaks. According to laboratory-based surveillance data from the National Microbiology Laboratory (NML), during large outbreaks of chikungunya in the Americas in 2014 and 2015, approximately 550 and 340, respectively, travel-related chikungunya cases were identified among people tested for chikungunya at the NML, compared to between 1 to 89 cases identified annually from 2016 to 2024. These data likely underestimate the true burden of travel-related cases, since chikungunya is not a nationally notifiable disease, laboratory-based surveillance does not capture all infections, and reported cases are influenced by testing practices and other contextual factors.

Preparations authorized for use in Canada

Preparations authorized for use in Canada may not be currently available for sale. Refer to Health Canada's Drug Product Database (DPD) for its drug status. Definitions of drug statuses can be found under DPD Terminology.

For complete prescribing information, consult the product leaflet or information contained within Health Canada's authorized product monograph available through the Drug Product Database.

Refer to Contents of immunizing agents authorized for use in Canada in Part 1 for a list of vaccines authorized for use in Canada and their contents.

Immunogenicity, efficacy and effectiveness

Data on vaccine efficacy or effectiveness for Chik-LAV are currently not available. Immunogenicity data from a large Phase 3 randomized control trial involving participants 18 years of age and older demonstrated high seroconversion at 29 days following a single dose of Chik-LAV (98.9%), which persisted out to 4 years in a subset of trial participants. Seroresponse rates did not vary significantly across age groups, with seroresponse rates of 98.6% in participants 18 to 64 years of age and 100% in participants 65 years of age and older, with titres remaining at levels presumed to be protective for at least 2 years. The antibody titres observed in these studies are believed to correlate with clinical protection.

Recommendations for use

Individuals 12 to 17 years of age

Health Canada has authorized Chik-LAV for use in individuals 12 to 17 years of age for the prevention of disease caused by the CHIKV. CATMAT has not yet provided guidance on the use of Chik-LAV in this age group.

Adults 18 to 64 years of age

Chik-LAV is generally not recommended for adults 18 to 64 years of age, but may be considered for individuals who are at high risk of infection, for example those who travel to an identified outbreak area, following an individualized assessment and discussion about the benefits and harms of Chik-LAV with a healthcare provider that takes into account the traveller's:

To determine if a destination is identified as experiencing an outbreak, consult the Government of Canada's Travel advice and advisories by destination page. Under the "Health" section of each destination page, look specifically for a "Level 2 Travel Health Notice".

Refer to the Travellers section for additional information.

It is unknown whether the presence of underlying health conditions (e.g., diabetes, hypertension, or heart disease) may increase the risk of SAEs in individuals 18 to 64 years of age. This factor should be considered as part of an individualized assessment for persons of any age, as these conditions have been reported to be associated with more serious outcomes from chikungunya infection and were present in most of the case reports of SAEs following vaccination with Chik-LAV.

Refer to Table 1 in the CATMAT statement on Recommendations for the use of chikungunya live attenuated vaccine (IXCHIQ) for examples of individualized assessments.

Adults 65 years of age and older

Chik-LAV is not recommended for use in individuals 65 years of age and older and these individuals are recommended to avoid travel to areas experiencing a chikungunya outbreak. To determine if a destination is identified as experiencing an outbreak, consult the Government of Canada's Travel advice and advisories by destination page. Under the "Health" section of each destination page, look specifically for a "Level 2 Travel Health Notice".

If travel cannot be avoided or delayed, a detailed discussion regarding the potential risks of infection and the risk for serious complications from vaccination including SAEs is necessary to support shared decision-making related to the receipt of Chik-LAV. Post-marketing surveillance data indicated that most SAEs following vaccination with Chik-LAV were reported in individuals in this age group with pre-existing health conditions. Refer to Safety and adverse events for additional information.

Refer to Table 1 in the CATMAT statement on Recommendations for the use of chikungunya live attenuated vaccine (IXCHIQ) for examples of individualized assessments.

Booster doses and re-immunization

The need for a booster dose following immunization with Chik vaccine has not been established.

Vaccination of specific populations

Pregnancy and breastfeeding

Chik-LAV is contraindicated in pregnant women and pregnant individuals. Data supporting the use of the Chik-LAV in pregnant women and pregnant individuals and individuals who are breastfeeding is limited. Available evidence is insufficient to determine its safety during pregnancy, embryofetal development, parturition, postnatal development, or breastfeeding, and it is unknown whether the vaccine is excreted in human milk.

For pregnant individuals who are unable to delay travel to an area experiencing a chikungunya outbreak, an in-depth discussion about the potential risks of infection, the risk for serious complications from vaccination including SAEs, and/or the lack of safety data for use in pregnancy is necessary to support shared decision-making related to receipt of Chik-LAV.

For those who could become pregnant, pregnancy should be avoided for one month following vaccination with Chik-LAV.

Refer to Immunization in pregnancy and breastfeeding in Part 3 for additional information about vaccination of women or individuals who are pregnant or breastfeeding.

Individuals who are immunocompromised

Chik-LAV is contraindicated in individuals who are immunocompromised due to the risk of disease caused by the vaccine strain. Data on the use of Chik-LAV in immunocompromised populations is limited.

For individuals who are immunocompromised and are unable to delay travel to an area experiencing a chikungunya outbreak, an in-depth discussion about the potential risks of infection, the risk for serious complications from vaccination including SAEs, and/or the lack of safety data for use in people who are immunocompromised is necessary to support shared decision-making related to receipt of Chik-LAV.

Refer to Immunization of immunocompromised persons in Part 3 for additional information about vaccination of people who are immunocompromised.

Travellers

Chik-LAV is not recommended for use in individuals aged 65 years or older and in individuals aged 18 to 64 years who are not at high risk of infection.

For individuals aged 18 to 64 years who are at high risk of infection, Chik-LAV may be considered. An individualized assessment and discussion between the traveller and their healthcare provider are necessary to assess the suitability of Chik-LAV vaccination.

An individualized assessment includes a discussion about the benefits and harms of Chik-LAV in the context of the traveller's exposure to chikungunya including disease activity at the destination, the length of travel and possibility of repeat travel to affected areas. Outbreaks of chikungunya are associated with a high risk of infection, and travellers would be more likely to choose to receive Chik-LAV when the estimated risk is the highest. To determine if a destination is identified as experiencing an outbreak, consult the Government of Canada's Travel advice and advisories by destination page. Under the "Health" section of each destination page, look specifically for a "Level 2 Travel Health Notice".

Travellers aged 18 to 64 years who are travelling to an outbreak area, as well as those who are planning longer trips and those who might undertake repeated travel to areas of risk, and/or those who might be more likely to suffer complicated or severe chikungunya disease may derive greater benefit from vaccination with Chik-LAV. Some pre-existing medical conditions (e.g., diabetes, hypertension, cardiac disease, or pre-existing joint disease) may result in an increased risk for severe chikungunya disease as well as vaccine-associated SAEs; as such, these conditions should be considered in the decision-making for the use of Chik-LAV.

Refer to Table 1 in the CATMAT statement on Recommendations for the use of chikungunya live attenuated vaccine (IXCHIQ) for examples of individualized assessments.

For additional travel-related advice on chikungunya prevention or Chik-LAV recommendations for travellers, refer to CATMAT's Recommendations for the use of chikungunya live attenuated vaccine (IXCHIQ), Recommendations for use, and Immunization of travellers in Part 3.

Serologic testing

Serologic testing is not indicated before or after receiving Chik-LAV.

Administration practices

Dose

Each dose of Chik-LAV is 0.5 mL after reconstitution.

Route of administration

Chik-LAV should be administered intramuscularly.

Concurrent administration of vaccines

There are no data on concurrent administration of Chik-LAV with other vaccines.

In general, live vaccines given by the parenteral route may be administered concurrently with other vaccines during the same visit, using different injection sites and separate needles and syringes. If two live parenteral vaccines are not administered concurrently, there should be a period of at least 4 weeks before the second live parenteral vaccine is given. When two live parenteral vaccines are given less than 4 weeks apart, the immune response to the second vaccine may be diminished by the immune response to the first vaccine.

However, it is recommended that Chik-LAV should not be given concurrently with other live or inactivated vaccines because there are no data on the safety and immunogenicity following concomitant administration and there is ongoing safety monitoring of Chik-LAV, that may be confounded by any concurrent administration. Refer to Timing of vaccine administration in Part 1 for additional information about concurrent administration of vaccines.

Storage requirements

Store Chik-LAV (vial with lyophilized powder and diluent) in a refrigerator at +2°C to +8°C. Do not freeze. If not used immediately, store the reconstituted vaccine at room temperature and use within 30 minutes.

Refer to Storage and handling of immunizing agents in Part 1 for additional information and recommendations.

Safety and adverse events

Common and very common adverse events

Common adverse events occur in 1% to less than 10% of vaccinees. Very common adverse events occur in 10% or more of vaccinees.

Among Chik-LAV recipients 18 years of age and older in the phase 3 clinical trial, the most common local adverse event was tenderness (10.6%) at the injection site. Very common systemic adverse reactions in the first 10 days following vaccination included headache (31.6%), fatigue (28.5%), myalgia (23.9%), arthralgia (17.2%), and fever (13.5 %). Most reactions reported following vaccination with Chik-LAV were mild to moderate.

Chikungunya-like adverse reactions (CLARs) were reported in the phase 3 clinical trial for 11.7% of Chik-LAV recipients, 1.6% of which were severe. CLARs are characterized by a group of symptoms that are typically observed in natural chikungunya infection. Symptoms occur within 30 days following vaccination and include fever and at least one of the following: arthralgia or arthritis, myalgia, headache, back pain, rash or certain skin symptoms, lymphadenopathy, or certain neurological, cardiac, or ocular symptoms. They were considered severe if they prevented daily activities and/or required medical attention.

Uncommon, rare, and very rare adverse events

Uncommon adverse events occur in 0.1% to less than 1% of vaccinees. Rare and very rare adverse events occur, respectively, in 0.01% to less than 0.1% and less than 0.01% of vaccinees.

Among the phase 3 clinical trial participants, 2 SAEs requiring hospitalization were found to be related to Chik-LAV; both individuals fully recovered. One participant experienced severe myalgia, mild arthralgia, tachycardia and tachypnea 1 to 2 days following vaccination, and the other experienced severe fever 4 days post-vaccination and was found to have hypovolemic hyponatremia with atrial fibrillation.

As of July 11, 2025, 28 SAEs following vaccination with Chik-LAV have been reported through post-marketing surveillance data from Europe and the United States. Most of these SAEs, including 3 deaths, were among individuals 65 years and older with pre-existing health conditions. In some the cases, the CHIKV strain used in the vaccine was detected, and the timing of SAE onset was generally consistent with what would be expected from a vaccine-related adverse event.

For information about post-vaccination observation and management of adverse events refer to Vaccine administration practices in Part 1 and Anaphylaxis and other acute reactions following vaccination in Part 2.

Guidance on reporting adverse events following immunization (AEFI)

To ensure the ongoing safety of vaccines in Canada, reporting of AEFIs by vaccine providers and other clinicians is critical, and in some jurisdictions, reporting is mandatory under the law.

Vaccine providers are asked to report AEFIs through their local public health unit. Specific AEFI reporting requirements may vary by province or territory. In general, any serious or unexpected adverse event felt to be temporally related to vaccination should be reported.

Refer to Vaccine safety and pharmacovigilance and Adverse events following immunization (AEFI) in Part 2 for additional information on vaccine safety, definitions of AEFIs, and reporting of AEFIs to public health.

Contraindications and precautions

Chik-LAV is contraindicated in persons with proven immediate or anaphylactic hypersensitivity to any component of the vaccine or its container. Refer to Contents of immunizing agents authorized for use in Canada in Part 1 for a list of vaccines authorized for use in Canada and their contents.

Refer to Contraindications and precautions in Part 2 for additional general information.

Chapter revision process

This chapter was developed based on guidance from the Committee to Advise on Tropical Medicine and Travel (CATMAT) statement on Recommendations for the use of chikungunya live attenuated vaccine (IXCHIQ) published on December 24, 2025.

Acknowledgements

This chapter was prepared by N Mohamed and reviewed by C Jensen, E Abrams, R Pless, T Nguyen, and the CATMAT Chikungunya Working Group.

The chapter is based on the CATMAT statement on Recommendations for the use of chikungunya live attenuated vaccine (IXCHIQ) prepared by P Lagacé-Wiens, S Schofield, I Bogoch, YG Bui, A Khatib, M Libman, T Nguyen, and K Plewes on behalf of CATMAT.

NACI gratefully acknowledges the contribution of: N Haddad.

Selected references

Canada Communicable Disease Report (CCDR). Travel-related dengue, Zika and chikungunya in Canada, 2024. Ottawa: Public Health Agency of Canada; 2025. Available from: https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2025-51/issue-9-september-2025/travel-related-dengue-zika-chikungunya-canada-2024.html

Committee to Advise on Tropical Medicine and Travel. CATMAT Recommendations for the use of chikungunya live attenuated vaccine (IXCHIQ). Ottawa: Public Health Agency of Canada; 2025. Available from: https://www.canada.ca/en/public-health/services/catmat/recommendations-use-chikungunya-vaccine.html

European Centre for Disease Prevention and Control. Chikungunya virus disease worldwide overview [updated 2025-11-13; cited 2025-11-25]. Available from: https://www.ecdc.europa.eu/en/chikungunya-monthly

FCPADM. Ferreira, ASV. da Silva, J. Recht, L. Guaraldo, MEL. Moreira, AM. de Siqueira, P. Gerardin, P. Brasil. Vertical transmission of chikungunya virus: A systematic review. [published 2021-04-23; cited 2025-12-16].

L. Petersen, A. Powers. Control of Communicable Diseases Manual. Chikungunya [updated 2021-01-22; cited 2025-11-25]. Available from: https://ccdm.aphapublications.org/doi/abs/10.2105/CCDM.2745.159?role=tab.

Valneva Austria GmbH. Product Monograph – IXCHIQ. August 2025.

World Health Organization (WHO). Chikungunya epidemiology update - June 2025 [updated 2025-06-11; cited 2025-11-25]. Available from: https://www.who.int/publications/m/item/chikungunya-epidemiology-update-june-2025

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2026-02-27