varicella virus vaccine (Varivax)

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Indications

Contraindications

Caution:

pregnancy-category -

safety in lactation ?

Dosage

  • children 12 months to 12 years: 0.5 mL SC
  • children >12 years & adults:
    • 2 doses of 0.5 mL SC separated by 4-8 weeks

Lyophilized powder for injection:

  • 0.5 mL single dose vials
  • store in freezer
  • can be stored refrigerated for 72 hours

Pharmacokinetics

  • elimination: liver
  • onset of action: 4-6 weeks after vaccination

Adverse effects

Drug interactions

Notes

Effectiveness:

  • 48% of vaccinated children vs 86% of unvaccinated children developed chickenpox upon exposure in a daycare center[4][5]
  • 73% effective if given at 12 months of age 99% effective if given at 15 months of age difference only applies to 1st year after vaccination[8][9]
  • unknown if vaccine will prevent shingles[6]
  • universal childhood varicella vaccination diminishes mortality
  • vaccinated individuals can still develop chicken pox, but their clinical course is usually milder than in unvaccinated patients[16]

More general terms

More specific terms

Additional terms

Component of

References

  1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  2. Jump up to: 2.0 2.1 Medical Knowledge Self Assessment Program (MKSAP) 11, 16. American College of Physicians, Philadelphia 1998, 2012
  3. Journal Watch 22(8):59, 2002 (vaccine effective in adults) Ampofo K et al Clin Infect Dis 34:774, 2002
  4. Jump up to: 4.0 4.1 Journal Watch 23(3):26, 2003 Galil K et al, N Engl J Med 347:1909, 2002 Gershon AA, N Engl J Med 347:1962, 2002
  5. Jump up to: 5.0 5.1 Prescriber's Letter 10(2):7 2003
  6. Jump up to: 6.0 6.1 Prescriber's Letter 10(4):21 2003
  7. Jump up to: 7.0 7.1 Prescriber's Letter 10(10):56 2003
  8. Jump up to: 8.0 8.1 Prescriber's Letter 11(3):16 2004 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=200308&pb=PRL (subscription needed) http://www.prescribersletter.com
  9. Jump up to: 9.0 9.1 Journal Watch 24(6):45, 2004 Vazquez M et al JAMA 291:851, 2004 PMID: https://www.ncbi.nlm.nih.gov/pubmed/14970064
  10. Journal Watch 25(6):46-47, 2005 Nguyen HQ, Jumaan AO, Seward JF. Decline in mortality due to varicella after implementation of varicella vaccination in the United States. N Engl J Med. 2005 Feb 3;352(5):450-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15689583
  11. Zhou F, Harpaz R, Jumaan AO, Winston CA, Shefer A. Impact of varicella vaccination on health care utilization. JAMA. 2005 Aug 17;294(7):797-802. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16106004
  12. Jump up to: 12.0 12.1 Prescriber's Letter 13(8): 2006 CDC's Advisory Committee Recommends Changes in Varicella Vaccinations Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220804&pb=PRL (subscription needed) http://www.prescribersletter.com
  13. Chaves SS et al, Loss of vaccine-induced immunity to varicella over time. N Engl J Med 2007, 356:1121-9
  14. Marin M, Guris D, Chaves SS, Schmid S, Seward JF; Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention (CDC). Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2007 Jun 22;56(RR-4):1-40. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/17585291 <Internet> http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5604a1.htm
  15. Jump up to: 15.0 15.1 Maglione MA et al Safety of Vaccines Used for Routine Immunization of US Children: A Systematic Review. Pediatrics; published online July 1, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25086160 <Internet> http://pediatrics.aappublications.org/content/early/2014/06/26/peds.2014-1079.full.pdf+html
    Byington CL Vaccines: Can Transparency Increase Confidence and Reduce Hesitancy? Pediatrics; published online July 1, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25086161 <Internet> http://pediatrics.aappublications.org/content/early/2014/06/26/peds.2014-1494.full.pdf+html
  16. Jump up to: 16.0 16.1 Baxter R, Tran TN, Ray P et al Impact of vaccination on the epidemiology of varicella: 1995-2009. Pediatrics. 2014 Jul;134(1):24-30 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24913796
  17. Jump up to: 17.0 17.1 Leung J, Harpaz R Impact of the Maturing Varicella Vaccination Program on Varicella and Related Outcomes in the United States: 1994-2012. J Ped Infect Dis (2015). August 12, 2015 http://jpids.oxfordjournals.org/content/early/2015/08/05/jpids.piv044.abstract