29-year-old patient with varicellaThese 2 varicella vaccines should not be confused with the varicella zoster vaccine, Zostavax, which is approved for use in adults who are 60 years of age and older for the prevention of shingles and postherpetic neuralgia.4
Answers to 6 common questions about the varicella vaccine1
- Can the varicella vaccine be co-administered with other childhood vaccines?
Yes. - What if a nonimmune pregnant women is exposed to chicken-pox?
You’ll need to consult your local health department about the possibility of administering varicella immune globulin. - Can the vaccine be administered to mothers who are breastfeeding their babies?
yes. - Can the vaccine be administered to those who live in a household with an immune-suppressed person?
yes, the risk of transmission of vaccine virus is very low. - What if a woman is inadvertently vaccinated while pregnant?
The risk during pregnancy is theoretical and to date, no cases of congenital varicella have resulted from inadvertent vaccination during pregnancy. - Will the vaccine prevent shingles later in life?
No one knows for sure. Surveillance is currently in progress, but long-term results are not available.
Pregnancy precludes vaccination
Varicella vaccine is contraindicated during pregnancy and in those who have had a severe allergic reaction to any vaccine component, including gelatin; have a malignancy of the blood, bone marrow, or lymphatic system; have a congenital or hereditary immunodeficiency; or are receiving systemic immunosuppressive therapy including those on the equivalent of 2 mg/kg, or >20 mg/day, of prednisone.
You should delay giving the vaccine to patients with an acute, severe illness. There is a potential for immune globulin containing products to interfere with the effectiveness of live virus vaccines. As a result, if a patient has received blood, plasma, or immune globulin, you should wait 3 to 11 months before giving the varicella vaccine. These products should also be avoided, if possible, for 2 weeks after the vaccine has been administered.
Avoid using quadrivalent MMRV in patients with HIV infection because it contains a higher quantity of varicella antigen than the single antigen product.
One final precaution: Patients should avoid taking salicylates for 6 weeks following vaccination because of the theoretical risk of Reye’s syndrome.