Drug information of Varicella-Zoster Vaccines
Varicella vaccine, also known as chickenpox vaccine, is a vaccine that protects against chickenpox
Mechanism of effect
Live, attenuated varicella virus stimulates active immunity to disease caused by varicella-zoster virus.
Conveys active immunity via stimulation of production of endogenously produced antibodies.
Onset: 4-6 weeks (seroconversion)
Duration: Antibody titers detected at 10 years following vaccination
Indicated for all adults without evidence of immunity to varicella
2 dose series: 0.5 mL SC, repeat at least 4 weeks later
Minimum age: 12 months
- 2 dose series: 0.5 mL SC
- 1st dose: 12-15 months
- 2nd dose: 4-6 years; may be administered before age 4 yr, provided at least 3 months have elapsed since the first dose
- Note: If the 2nd dose was administered at least 4 weeks after the first dose, it can be accepted as valid
Catch-up vaccination aged 7-18 yr
- 7-12 years: 0.5 mL SC x2 doses at least 3 months apart; if the second dose was administered at least 4 weeks after the first dose, it can be accepted as valid
- ≥13years: 0.5 mL SC x2 doses at least 4 weeks apart
Drug contraindicationspregnancy , Tuberculosis - Active , Immune system definition
Hypersensitivity to gelatin, neomycin
HIV: CD4+ count <200 cells/mcL
Immunosuppressed or immunodeficient patients with lymphomas, leukemia, or malignant neoplasms affecting bone marrow or lymphatic system
Patients receiving immunosuppressive therapy including immunosuppressive doses of corticosteroids
Primary and acquired immunodeficiency states
Current febrile illness
Side effectsSeizures , vertigo , Peripheral edema , fever , Stevens-Johnson syndrome , Injection-site reaction , Anaphylactic reaction , aplastic anemia, , swelling of the face , Herpes Zoster , Varicella-Zoster
Injection site swelling/rash/pruritus/erythema -Fever >102°F [39°C] -Anaphylaxis (including anaphylactic shock) and related phenomena such as angioneurotic edema, facial edema, and peripheral edema-Necrotizing retinitis (in immunocompromised individuals)-Aplastic anemia- thrombocytopenia (including ITP)-Varicella (vaccine strain)-Encephalitis- cerebrovascular accident-transverse myelitis-Guillain-Barré syndrome- Bell palsy-ataxia- nonfebrile seizures-aseptic meningitis- dizziness- paresthesia-Pharyngitis- pneumonia/pneumonitis-Stevens-Johnson syndrome-erythema multiforme- Henoch-SchÖnlein purpura-secondary bacterial infections of skin and soft tissue, including impetigo and cellulitis-herpes zoster
InteractionsOxaliplatin , Ifosfamide , Procarbazine , Thymoglubin , Lomustine , Methotrexate , Nelarabine , Tildrakizumab , Ustekinumab , Alefacept , Aflibercept , Axicabtagene ciloleucel , Pralatrexate , Ibrutinib , trabectedine , Clofarabine , Tositumomab , Cabazitaxel , Bendamustine , Canakinumab , Basiliximab , Melphalan , prednisone , Certolizumab , Prednisolone , Loteprednol , Mechlorethamine , Sarilumab , Tisagenlecleucel , Duvelisib , Alemtuzumab , Dupilumab , Ocrelizumab , Ofatumumab , vedolizumab , Dasatinib , Daclizumab , secukinumab , alirocumab , Famtrastuzumab , Niraparib
Belimumab-certolizumab pegol-famciclovir-ibrutinib-ifosfamide-ixekizumab-lomustine-mechlorethamine-melphalan-methotrexate-onasemnogene abeparvovec-oxaliplatin-procarbazine-secukinumab-ustekinumab-Adalimumab-alefacept-anakinra-antithymocyte globulin equine-antithymocyte globulin rabbit-aspirin-aspirin rectal-aspirin/citric acid/sodium bicarbonate-axicabtagene ciloleucel-azathioprine-balsalazide-baricitinib-basiliximab-budesonide-cabazitaxel-canakinumab-choline magnesium trisalicylate-cortisone-cyclosporine-deflazacort-dexamethasone-diflunisal-etanercept-everolimus-fingolimod-fludrocortisone-glatiramer-golimumab-guselkumab-hydrocortisone-hydroxychloroquine sulfate-hydroxyurea-infliximab-leflunomide-mercaptopurine-mesalamine-methylprednisolone-muromonab CD3-mycophenolate-ocrelizumab-ozanimod-prednisolone-prednisone-rilonacept-risankizuma-rituximab-rituximab-hyaluronidase-salicylates (non-asa)-salsalate-sarilumab-siponimod-sirolimus-sulfasalazine-tacrolimus-temsirolimus-tildrakizumab-tisagenlecleucel-tocilizumab-triamcinolone acetonide injectable suspension-upadacitinib-ustekinumab-vedolizumab-willow bark-anthrax immune globulin-belatacept-cytomegalovirus immune globulin (CMV IG)-dengue vaccine-hepatitis B immune globulin (HBIG)-immune globulin IM (IGIM)-immune globulin IV (IGIV)-immune globulin SC-obinutuzumab-rabies immune globulin, human (RIG)-tetanus immune globulin (TIG)-vaccinia immune globulin intravenous-chloroquine-Rho(D) immune globulin
-Syncope accompanied by transient visual disturbances, weakness, or tonic-clonic movements reported with injectable vaccines.
-Postpone administration in patients with moderate or severe illness with or without fever; may administer to patients with mild illness with or without fever.
-Avoid pregnancy for 3 months following therapy.
-Avoid taking salicylates for 6 weeks after vaccination (may increase risk of Reye's syndrome.
-Anaphylactoid/hypersensitivity reactions: Immediate treatment (including epinephrine 1 mg/mL) for anaphylactoid and/or hypersensitivity reactions should be available during vaccine use.
-Cases of encephalitis or meningitis caused by vaccine strain varicella virus have been reported in immunocompetent individuals previously vaccinated with varicella virus vaccine months to years after vaccination.
Points of recommendation
- Thermolabile: store at temperature -20°C or colder
-Avoid contact with high risk individuals up to 5 wk after vaccination
-Do not give concurrently w/ any form of immune globulin
- Medications active against the herpesvirus family (eg, acyclovir, famciclovir, valacyclovir) may interfere with the varicella vaccine
- Varicella vaccine and antibody-containing products (eg, immune globulin, blood products) should not be administered simultaneously
-Use is contraindicated.
-Pregnancy should be avoided for 1 to 3 months after vaccination.
Breast feeding warning
Not known if excreted in breast milk; use caution