Dosing and uses of Varivax (varicella virus vaccine live)
Adult dosage forms and strengths
vaccine
- 1350 plaque forming units/0.5mL
Varicella Immunization
Indicated for all adults without evidence of immunity to varicella
2 dose series: 0.5 mL SC, repeat at least 4 weeks later
Vaccination Schedules
Up-to-date vaccination schedules available at https://www.cdc.gov/vaccines/schedules/
Pediatric dosage forms and strengths
vaccine
- 1350 plaque forming units/0.5mL
Varicella Immunization
Indicated for routine immunization (ACIP guidelines)
Minimum age: 12 months
Routine vaccination
- 2 dose series: 0.5 mL SC
- 1st dose: 12-15 months
- 2nd dose: 4-6 years; may be administered before age 4 yr, provided at least 3 months have elapsed since the first dose
- Note: If the 2nd dose was administered at least 4 weeks after the first dose, it can be accepted as valid
Catch-up vaccination aged 7-18 yr
- 7-12 years: 0.5 mL SC x2 doses at least 3 months apart; if the second dose was administered at least 4 weeks after the first dose, it can be accepted as valid
- ≥13years: 0.5 mL SC x2 doses at least 4 weeks apart
Varivax (varicella virus vaccine live) adverse (side) effects
Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System (VAERS), 1-800-822-7967
>10%
Injection site swelling/rash/pruritus/erythema (20%)
Fever >102°F [39°C] (15%)
Postmarketing Reports
Body as a whole: Anaphylaxis (including anaphylactic shock) and related phenomena such as angioneurotic edema, facial edema, and peripheral edema
Eye disorders: Necrotizing retinitis (in immunocompromised individuals)
Hemic and lymphatic system: Aplastic anemia; thrombocytopenia (including ITP)
Infections and infestations: Varicella (vaccine strain)
Nervous/psychiatric: Encephalitis; cerebrovascular accident; transverse myelitis; Guillain-Barré syndrome; Bell palsy; ataxia; nonfebrile seizures; aseptic meningitis; dizziness; paresthesia
Respiratory: Pharyngitis; pneumonia/pneumonitis
Skin: Stevens-Johnson syndrome; erythema multiforme; Henoch-Schönlein purpura; secondary bacterial infections of skin and soft tissue, including impetigo and cellulitis; herpes zoster
Warnings
Contraindications
Hypersensitivity to gelatin, neomycin
Pregnancy
HIV: CD4+ count <200 cells/mcL
Immunosuppressed or immunodeficient patients with lymphomas, leukemia, or malignant neoplasms affecting bone marrow or lymphatic system
Patients receiving immunosuppressive therapy including immunosuppressive doses of corticosteroids
Primary and acquired immunodeficiency states
Current febrile illness
Active TB
Cautions
Avoid contact with high risk individuals up to 5 wk after vaccination
Do not give concurrently w/ any form of immune globulin
Thermolabile: store at temperature -20°C or colder
Syncope accompanied by transient visual disturbances, weakness, or tonic-clonic movements reported with injectable vaccines
Postpone administration in patients with moderate or severe illness with or without fever; may administer to patients with mild illness with or without fever
Avoid pregnancy for 3 months following therapy
Avoid taking salicylates for 6 weeks after vaccination (may increase risk of Reye's syndrome
Pregnancy and lactation
Pregnancy category: X
Lactation: Not known if excreted in breast milk; use caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Varivax (varicella virus vaccine live)
Mechanism of action
Live, attenuated varicella virus stimulates active immunity to disease caused by varicella-zoster virus
Conveys active immunity via stimulation of production of endogenously produced antibodies
Pharmacokinetics
Onset: 4-6 weeks (seroconversion)
Duration: Antibody titers detected at 10 years following vaccination
