Vaccine, varicella-zoster: Indication, Dosage, Side Effect, Precaution

This information is not country-specific. Please refer to the Malaysia prescribing information.

Generic Medicine Info

Indications and Dosage

Intramuscular, Subcutaneous
Active immunisation against varicella infection

Adult: Each 0.5 mL contains live, attenuated varicella-zoster virus (VZV) Oka/Merck strain ≥10^3.3 plaque-forming units (PFU), or ≥1,350 PFU: 0.5 mL for 2 doses via deep SC or IM inj, doses are given 4-8 weeks apart.
Child: 9 months to 12 years (or 1-12 years, based on product used) 0.5 mL for 2 doses via deep SC or IM inj; the 2nd dose is to be given after an interval of at least 3 months (or 6 months based on national recommendations); ≥13 years Same as adult dose.

Subcutaneous
Prevention of herpes zoster, Prevention of herpes zoster-related postherpetic neuralgia

Adult: Each 0.65 mL contains live, attenuated VZV Oka/Merck strain ≥19,400 PFU: ≥50 years 0.65 mL for 1 dose.

Reconstitution

Reconstitute vaccine using the total volume of the provided diluent. Agitate to mix thoroughly.

Contraindications

Hypersensitivity. Immunosuppression or immuinodeficiency (e.g. HIV infection, leukaemia, lymphoma or other malignant neoplasms, history of primary or acquired immunodeficiency states), active infection (e.g. untreated TB). Pregnancy and lactation.

Special Precautions

Patient with mild acute illness with or without low grade fever, personal or family history of febrile convulsions.

Adverse Reactions

Significant: Syncope.
Blood and lymphatic system disorders: Lymphadenopathy.
Ear and labyrinth disorders: Otitis.
Eye disorders: Conjunctivitis.
Gastrointestinal disorders: Abdominal pain, anorexia, aphthous stomatitis, constipation, diarrhea, nausea, vomiting.
General disorders and administration site conditions: Fatigue, fever, irritability, chills, malaise; injection site reactions (e.g. erythema, bruising, haematoma, swelling).
Musculoskeletal and connective tissue disorders: Neck stiffness, arthralgia, myalgia.
Nervous system disorders: Headache.
Psychiatric disorders: Somnolence.
Reproductive system and breast disorders: Herpes labialis.
Respiratory, thoracic and mediastinal disorders: Cough, rhinitis, respiratory tract disease, pharyngitis.
Skin and subcutaneous tissue disorders: Varicella-like rashes, contact dermatitis, pruritus.
Potentially Fatal: Severe hypersensitivity reactions (e.g. anaphylaxis).

Monitoring Parameters

Monitor for rash, fever, anaphylaxis and syncope for 15 minutes following administration.

Drug Interactions

Reduced immune response or risk of generalised infection when used concomitantly with immunosuppressants (e.g. corticosteroids). Concomitant treatment with salicylates (e.g. aspirin) may lead to Reye’s syndrome.

Lab Interference

May interfere with tuberculin tests.

Action

Description:
Mechanism of Action: Varicella-zoster virus vaccine promotes immunity to varicella by inducing both cell mediated and humoral immune responses to varicella-zoster virus (VZV). It also provides strong protection against herpes zoster and herpes-zoster-related post-herpetic neuralgia (PHN) in older patients (≥50 years) by eliciting an immune response to VZV.
Onset: Seroconversion: Approx 4-6 weeks.
Duration: 10 years.

Storage

Store between 2-8°C. Do not freeze. Protect from light.

MIMS Class

Vaccines, Antisera & Immunologicals

ATC Classification

J07BK - Varicella zoster vaccines ; Used for active immunizations.

References

Anon. Varicella Virus Vaccine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 04/07/2018.

Buckingham R (ed). Varicella-Zoster Vaccines. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/07/2018.

Joint Formulary Committee. Varicella-Zoster Vaccines. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/07/2018.

Varivax Injection, Powder, Lyophilized, for Suspension (Merck Sharp & Dohme Corp.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 04/07/2018.

Zostavax (Merck Sharp & Dohme Corp.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 19/07/2018.

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