Zoster Vaccine, Live
Class: Vaccines, viral
- Injection, lyophilized powder for suspension 19,400 plaque-forming units (PFU) of Oka/Merck varicella-zoster virus (live)
Induces development of immune responses against varicella-zoster virus.
Indications and Usage
Prevention of herpes zoster (shingles) in persons 50 y of age and older.
Immunosuppression or immunodeficiency, including a history of primary or acquired immunodeficiency states (eg, leukemia, lymphoma or other malignant neoplasms affecting bone marrow or lymphatic system, AIDS or other clinical manifestations of infection with HIV); patients receiving immunosuppressive therapy; women who are pregnant or may become pregnant during or within 3 months of treatment; history of anaphylactic/anaphylactoid reaction to gelatin, neomycin (excluding contact dermatitis to neomycin), or any component of the vaccine.
Dosage and AdministrationAdults 50 y of age and older
Subcutaneous 0.65 mL as a single dose.
- For subcutaneous injection only; do not inject intravascularly or IM.
- Administer as a single dose in the deltoid region of the upper arm.
- Use only sterile syringes free of preservatives, antiseptics, and detergents for each injection.
- Store the vaccine frozen and reconstitute immediately upon removal from the freezer using the supplied diluent.
- Store the diluent separately at room temperature or in the refrigerator.
- To reconstitute the vaccine, withdraw the entire contents of the diluent vial into a syringe and mix thoroughly by gentle agitation.
- The vaccine is a semi-hazy to translucent, off-white to pale yellow liquid when reconstituted.
- Administer the vaccine immediately after reconstitution to minimize loss of potency.
Store vaccine frozen at an average temperature of 5°F or cooler until reconstitution. Protect from light. Store diluent at room temperature (68° to 77°F) or in the refrigerator (36° to 46°F).
Discard reconstituted vaccine if not used within 30 min. Do not freeze reconstituted vaccine.
Drug InteractionsAntineoplastic agents (eg, busulfan, carmustine, docetaxel, melphalan, mercaptopurine, paclitaxel, thiotepa)
The risk of live zoster vaccine–induced adverse reactions may be increased by coadministration of antineoplastic agents. Administration of live zoster vaccine to patients who are receiving antineoplastic agents should be deferred.Antineoplastic monoclonal antibodies (eg, alemtuzumab)
The immune response to live zoster vaccine may be reduced. Avoid coadministration.Immunosuppressive agents (eg, fingolimod, ustekinumab)
Zoster vaccine is a live vaccine and the risk of disseminated disease is greater in patients who are immunosuppressed. Coadministration is contraindicated.Pneumococcal vaccine polyvalent
A reduced response to live zoster vaccine has been observed in individuals who received these vaccines concurrently compared with those who received these vaccines 4 wk apart. Administer the vaccines at least 4 wk apart.
Headache (9%); asthenia (1%).
Skin disorder (1%).
Hypersensitivity reactions, including anaphylactic reactions (postmarketing).
Pain (54%); erythema (48%); swelling (40%); pain/tenderness (34%); pruritus (11%); warmth (4%); hematoma (2%); induration (1%).
Pulmonary edema, respiratory tract infection (2%); respiratory disorder (1%).
Fever, flu syndrome (2%); pain in extremity (1%).
Category Undetermined .
Not indicated for prevention of primary varicella infection (chickenpox); do not use in children or adolescents.
Serious adverse reactions, including anaphylaxis, have occurred.
Defer vaccination in acute illness (eg, presence of fever) or in persons with active untreated tuberculosis.
Zoster vaccine may result in disseminated disease in immunosuppressed or immunodeficient individuals.
Duration of protection beyond 4 y after vaccination is unknown.
Transmission of vaccine virus
May occur between vaccinees and susceptible contacts.
- Obtain patient history, including drug history and any known allergies.
- Question recipient about reactions to previous vaccines.
- Inform recipient of benefits and risks.
- Provide recipient with a copy of the patient information leaflet and discuss any questions or concerns.
- Inform recipient of the potential risk of transmitting the vaccine virus to susceptible individuals, such as immunosuppressed or immunodeficient individuals or pregnant women who have not had chickenpox.
- Caution patient to avoid pregnancy for 3 mo after vaccination.
- Instruct recipient to report any adverse reactions to health care provider.
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