Drug information of Varicella-Zoster Vaccines

Varicella-Zoster Vaccines

Drug group: 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.

Pharmacokinetics

Onset: 4-6 weeks (seroconversion)

Duration: Antibody titers detected at 10 years following vaccination

Drug indications

Varicella-Zoster

Varicella Immunization

Dosage

Indicated for all adults without evidence of immunity to varicella

2 dose series: 0.5 mL SC, repeat at least 4 weeks later

PEDIATRIC

Minimum age: 12 months

Routine vaccination

  • 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 contraindications

pregnancy , Tuberculosis - Active , Immune system definition

Hypersensitivity to gelatin, neomycin

Pregnancy

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

Active TB

Side effects

Seizures , 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

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Alerts

-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

Pregnancy level

X

X

-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

Drug forms

Varivax

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