Varicella-Zoster Vaccine (Zoster, Live Attenuated)

Registered South African indications:

• Immunisation against herpes zoster
• Prevention of post-herpetic neuralgia

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Hypersensitivity to neomycin
• Pregnancy
• Primary and acquired immunodeficiency states due to conditions such as
  - Acute and chronic leukaemia's
  - Lymphoma
  - Other conditions affecting the bone marrow or lymphatic system
  - Immunosuppression due to HIV/AIDS
  - Cellular immune deficiencies
• Immunosuppressive therapy (including high-dose corticosteroids); however, varicella-zoster vaccine is not contraindicated for use in individuals who are receiving topical/inhaled corticosteroids or low-dose systemic corticosteroids or in patients who are receiving corticosteroids as replacement therapy, e.g., for adrenal insufficiency
• Active, untreated tuberculosis

Cautions

• Breastfeeding
• Severe thrombocytopenia 
• Coagulation disorder
• Moderate to severe acute febrile illness or infection

Forms avail. in SA and covered in this monograph: inj

Prevention of herpes zoster
- For immunization of individuals older than 50 years
Prevention of herpes zoster-related post-herpetic neuralgia
- For immunization of individuals older than 50 years

• SC: 0.65ml, as a single dose

Not established for use in children

Pregnancy

• Contraindicated

Breastfeeding

• Caution; not recommended

Renal Impairment

• No dose adjustment recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• No dose adjustment recommended

Central Nervous System Disorders

• Headache

Gastrointestinal Disorders

• Nausea

Musculoskeletal Disorders

• Arthralgia
• Myalgia
• Pain in extremity

Skin and Subcutaneous Tissue Disorders

• Varicella 
• Herpes zoster
• Rash
• Injection site reactions

Immune, Blood and Lymphatic System Disorders

• Lymphadenopathy
• Hypersensitivity reactions
• Anaphylaxis

Sensory Disorders

• Necrotizing retinitis

• Pneumococcal polysaccharide vaccine
• Antiviral agents

None routine

The live, attentuated varicella-zoster vaccine stimulates the production of antibodies to the varicella-zoster virus.

Injection (per 0.65ml) 19400pfu

• Zostavax (MSD) originator