Varicella vaccine

Vaccinations containing live organisms are not administered within 3 months of immune globulin administration because antibodies in the globulin preparation may interfere with the immune response to the vaccination. Corticosteroids, antineoplastic dru, and radiation therapy depress the immune system to such a degree that insufficient numbers of antibodies are produced to prevent the disease. When the salicylates are administered with the varicella vaccination, there is an increased risk of Reye s syndrome developing. 

Varicella vaccine. Varicella vaccine is recommended at any visit at or after age 12 months for susceptible children, ie, those who lack a reliable history of chickenpox. Susceptible persons aged >13 years should receive two doses, given at least 4 weeks apart. 

IGIM should be injected into a deltoid or gluteal muscle. It does not affect the immune response of inactivated vaccines, oral polio virus, or yellow fever vaccine. The administration of live vaccines [e.g., measles, mumps, rubella (MMR) vaccine] concomitantly with IGIM may decrease the immune response significantly thus, MMR and varicella vaccine should be delayed for at least 3 and 5 months, respectively, after IGIM has been administered. Additionally, IGIM should not be given within 2 weeks of the MMR administration or within 3 weeks of the varicella vaccine to maximize the efficacy of the immunization.1... 

The varicella vaccine is relatively new and has only been recommended for use since 1996, therefore its true impact on chickenpox and herpes zoster is not yet known. Its continued use will undoubtedly change the epidemiology of these diseases. 

The varicella vaccine is made up of an attenuated Oka strain of varicella zoster virus. This is a live attenuated vaccine. Attenuation was achieved by performing serial passages through human embryonic lung cells, embryonic guinea pig cells, and human diploid cells. 

Varicella vaccine should be administered after 12 months of age and a second dose at 4 years of age. Adolescents and adults without evidence of immunity to varicella zoster should receive two doses of varicella vaccine given 4 to 8 weeks apart. Varicella vaccine is available as a single-component vaccine or in combination with measles, mumps, and rubella vaccine. 

There are several combination vaccines available in the United States. One of the most popular pediatric combinations is Pediarix a combination of diphtheria and tetanus toxoids, acellular pertussis, inactivated poliovirus, and hepatitis B vaccines. ComVax is a combination of Haemophilus influenzae type b and hepatitis B vaccines. The most recent combination is ProQuad which contains measles, mumps, rubella, and varicella vaccines. The only combination available for adults is Twinrix which has hepatitis A and hepatitis B vaccines. 

Following hematopoietic stem cell transplantation the patient will need virtually all routine vaccines to be administered again however, the patient will not be able to mount an adequate response for 6 to 12 months post-transplant. Diphtheria, tetanus, acellular pertussis, Haemophilus influenzae type b, hepatitis B, pneumococcal, and inactivated poliovirus should be given at 12,14, and 24 months post-hematopoietic stem cell transplantation. Inactivated influenza vaccine should be given yearly, starting 6 months after transplant. Measles, mumps and rubella can be given 2 years after transplant and varicella vaccine is contraindicated.16... 

Household contacts of immunocompromised persons should have all routine vaccines as scheduled, including yearly influenza vaccination. Children in the household may receive live virus vaccines without special precautions however, if a rash develops following varicella vaccination, contact should be avoided with the immunocompromised host until the rash resolves. 

Most health care workers are at risk for exposure to many diseases in the normal course of their work. Additionally, health care workers may transmit vaccine-preventable diseases to their patients. At the time of employment and on a regular basis, health care workers should be screened for immunity to measles, rubella, and varicella if found to be non-immune, the measles, mumps, and rubella, and varicella vaccines should be administered. The hepatitis B series should be given if not already completed. Tetanus should be updated and given every 10 years. Health care personnel in hospitals and ambulatory settings with direct patient contact should receive Tdap if not already received an interval as short as 2 years from the last tetanus-containing vaccine should be used. Priority for receiving Tdap should be given to personnel with direct contact with infants less than 12 months of age. 

Administer the second dose of varicella vaccine at age 4-6 years. Varicella vaocine may be administered before age 4-6 years, provided that >3 months have elapsed since the first dose and both doses are administered at age >12 months. If second dose was administered >28 days following the first dose, the second dose does not need to be repeated. 

Administer 2 doses of varicella vaccine to persons without evidence of immunity. 

Administer 2 doses of varicella vaccine to persons aged <13 years at least 3 months apart. Do not repeat the second dose, if administered >28 days after the first dose. 

The second dose of varicella vaccine is recommended routinely at age 4-6 years but may be administered earlier if desired. 

Assess pregnant women for evidence of varicella immunity. Women who do not have evidence of immunity should receive the first dose of varicella vaccine upon completion or termination of pregnancy and before discharge from the health-care facility. The second dose should be administered 4-8 weeks after the first dose. 

The vaccine is contraindicated in immunosuppressed or pregnant patients. Children with asymptomatic or mildly symptomatic HIV should receive two doses of varicella vaccine 3 months apart. 

Chickenpox or varicella is caused by the varicella zoster virus (VZV). Varicella vaccine is indicated for active immunisation against varicella in healthy subjects and their susceptible healthy close contacts from the age of 12 months onwards. 

Varicella vaccine is a lyophilized preparation of the Oka strain of live attenuated varicella virus obtained by propagation of the virus in MRC human diploid cell culture. 

Varicella vaccine produces an attenuated clinically inapparent varicella infection in susceptible subjects. 

T. Levien, D. Baker, Reviews of naproxen enteric coated and varicella vaccine Hasp Pharm 30 1011-1024 (1995). 

Varicella-Zoster Immunization. Immunization against varicella was approved in the United States in 1995 and is administered to children 12 to 18 months of age or older if they have not had chickenpox. It has been shown to be most effective in the year after vaccination however, breakthrough disease was noted but foimd to be mild. Varicella vaccination reduces the number of related deaths, especially in children aged 1 to 4 years,... 

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