Generic Name: varicella virus vaccine (Subcutaneous route)
var-i-SEL-a VYE-rus VAX-een
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
- Powder for Solution
Therapeutic Class: Vaccine
Uses For Zostavax
Varicella virus vaccine is an active immunizing agent that is given to protect against infection caused by the varicella-zoster virus (VZV). The vaccine works by causing the body to produce its own protection (antibodies) against the virus.
Varicella (commonly known as chickenpox) is an infection that is easily spread from one person to another. Chickenpox is usually a mild infection but sometimes it can cause serious problems, such as pneumonia, inflammation of the brain, and a rare disease called Reye's syndrome.
Immunization against chickenpox is recommended for anyone 12 months of age and older who has not had chickenpox. Immunization against chickenpox is not recommended for infants younger than 12 months of age.
You can be considered to be immune to chickenpox only if you have received the right number of varicella vaccine doses (1 dose if you are between 12 months and 12 years of age; or 2 doses if you are 13 years of age or older). You also are considered to be immune if you have a doctor's diagnosis of a previous chickenpox infection or if you have had a blood test showing that you are immune to varicella.
Varicella virus vaccine (Zostavax®) is also used for the prevention of herpes zoster (commonly known as shingles) in people 50 years of age and older.
This vaccine is to be administered only by or under the supervision of your doctor or other authorized health care professional.
Before Using Zostavax
In deciding to use a vaccine, the risks of taking the vaccine must be weighed against the good it will do. This is a decision you and your doctor will make. For this vaccine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Varivax® (for preventing chickenpox)—Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of varicella virus vaccine in children 1 year of age and older. However, varicella virus vaccine is not recommended for infants younger than 12 months of age.
Zostavax® (for preventing shingles)—This vaccine should not be used in children.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of varicella virus vaccine in the elderly.
Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this vaccine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Receiving this vaccine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Certolizumab Pegol
- Choline Magnesium Trisalicylate
- Cytarabine Liposome
- Daunorubicin Citrate Liposome
- Doxorubicin Hydrochloride
- Doxorubicin Hydrochloride Liposome
- Gallium Nitrate
- Mycophenolic Acid
- Pneumococcal Vaccine Polyvalent
- Salicylic Acid
- Sodium Salicylate
- Sodium Thiosalicylate
- Trolamine Salicylate
- Uracil Mustard
- Vincristine Sulfate Liposome
Receiving this vaccine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of this vaccine. Make sure you tell your doctor if you have any other medical problems, especially:
- Blood disorder (weak immune system) or
- Bone marrow cancer or
- Gelatin allergy, history of or
- Illness with fever or
- Immune deficiency condition, or family history of or
- Leukemia (cancer of the blood) or
- Lymphoma (cancer of the immune system) or
- Neomycin allergy, history of or
- Neutropenia (low white blood cell count) or
- Receiving immunosuppressive treatment (e.g., steroid medicine such as dexamethasone or prednisone) or
- Tuberculosis, active and untreated—Should not be used in patients with these conditions.
Proper Use of varicella virus vaccine
This section provides information on the proper use of a number of products that contain varicella virus vaccine. It may not be specific to Zostavax. Please read with care.
A nurse or other trained health professional will give you or your child this vaccine. This vaccine is given as a shot under your skin (usually in the upper arms).
Children 12 months to 12 years of age may need a second shot within 3 months after receiving the first dose of Varivax®. Teenagers and adults should have a "booster" shot 4 to 8 weeks after the first dose of this vaccine.
Adults receiving Zostavax® should receive only one dose of the vaccine unless your doctor tells you otherwise.
This vaccine comes with a patient information insert. Make sure you understand all of the information in the insert. Ask your doctor if you have any questions.
Tell your doctor before receiving this vaccine if you are severely ill or if you have a fever greater than 101.3 °F.
This vaccine needs to be given on a fixed schedule. If you or your child missed the scheduled dose, call your doctor or your child’s doctor for another appointment as soon as possible.
Precautions While Using Zostavax
It is very important that you or your child return to your doctor’s office at the right time if you or your child needs a second dose of the vaccine. Be sure to notify your doctor of any side effects that occur after your child receive this vaccine.
Do not become pregnant for 3 months after receiving varicella virus vaccine without first checking with your doctor. There is a chance that this vaccine may cause problems during pregnancy. If you think you have become pregnant, tell your doctor right away. Your doctor may want you to join a pregnancy registry for patients receiving this vaccine.
Zostavax® should not be used in place of Varivax®.
Zostavax® should not be used in children.
Tell your doctor that you or your child have received this vaccine:
- If you are to receive blood transfusions or other blood products within 5 months of receiving this vaccine.
- If you are to receive varicella-zoster immune globulin (VZIG) or other immune globulins within 2 months after receiving this vaccine.
- If you are to receive any other live virus vaccines within 1 month of receiving this vaccine.
This vaccine may cause serious types of allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth after you receive the vaccine.
Do not take aspirin or medicines that contain aspirin (such as certain cold medicines) for 6 weeks after receiving this vaccine. Carefully check the label of any pain, headache, or cold medicine you or your child use to be sure it does not contain aspirin or salicylic acid.
You or your child may be able to pass the virus to other people after getting this vaccine. You or your child should avoid close contact with people at high risk for getting chickenpox for 6 weeks after receiving this vaccine. People who are most at risk of catching the virus from you are pregnant women, newborn babies, and people whose bodies cannot fight infection (such as with bone marrow disease, cancer drug treatment, or AIDS). Talk to your doctor about this risk.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Zostavax Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:More common
- Fever over 39 °C (102 °F)
- Blue lips and fingernails
- chest pain
- chickenpox-like skin rash
- coughing that sometimes produces a pink frothy sputum
- decreased urine output
- difficult, fast, or noisy breathing, sometimes with wheezing
- dilated neck veins
- extreme fatigue
- general feeling of discomfort or illness
- increased sweating
- irregular breathing
- irregular heartbeat
- pale skin
- shortness of breath
- swelling of the ankles, face, fingers, feet, or lower legs
- tightness in the chest
- troubled breathing
- weight gain
- Black, tarry stools
- blood in the urine or stools
- convulsions (seizures) with high fever
- difficulty with breathing or swallowing
- itching, especially of the feet or hands
- muscle or joint pain
- pinpoint red spots on the skin
- reddening of the skin, especially around the ears
- severe or continuing headache
- stiff neck
- swelling of the glands in the neck
- thickening of bronchial secretions
- unusual bleeding or bruising
- unusual tiredness or weakness, sudden and severe
- Back pain, sudden and severe
- bleeding gums
- blistering, peeling, or loosening of the skin
- bloating or swelling of the face, arms, hands, lower legs, or feet
- bloody nose
- blurred vision
- bruising more easily
- convulsions (seizures)
- fast heartbeat
- heavier menstrual periods
- inability to move the arms and legs
- inability to speak
- large, flat, blue, or purplish patches in the skin
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- loss of bladder control
- muscle spasm or jerking of all extremities
- painful blisters on the trunk of the body
- painful knees and ankles
- pale skin
- pinpoint red spots on the skin
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- raised red swellings on the skin, buttocks, legs, or ankles
- rapid weight gain
- red irritated eyes
- red skin lesions, often with a purple center
- shakiness and unsteady walk
- skin rash
- slurred speech
- sores, ulcers, or white spots in the mouth or on the lips
- stomach pain
- sudden loss of consciousness
- sudden numbness and weakness in the arms and legs
- swelling or puffiness of the face
- swollen or painful glands
- temporary blindness
- tingling of the hands or feet
- unsteadiness, trembling, or other problems with muscle control or coordination
- unusual weight gain or loss
- weakness in the arm or leg on one side of the body, sudden and severe
- weakness of the muscles in your face
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- Fever of 37.7 °C (100 °F) or higher, but not above 39 °C (102 °F)
- hives, itching, pain, redness, soreness, tenderness, or warmth at the injection site
- Common cold
- cracked, dry, or scaly skin
- diaper rash
- disturbed sleep
- dry skin
- heat rash or prickly heat
- lack or loss of strength
- loss of appetite
- muscle aching or cramping
- muscle stiffness
- runny nose
- skin rash, encrusted, scaly, and oozing
- sore throat
- stuffy nose
- swollen joints
- Bacterial skin infections
- body aches or pain
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- difficulty with moving
- dryness or soreness of the throat
- pain, redness, swelling, tenderness, or warmth on the skin
- red rash with watery, yellow-colored, or pus filled blisters
- tender, swollen glands in the neck
- thick yellow to honey-colored crusts
- voice changes
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Zostavax side effects (in more detail)
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