Zoster Vaccine (Zostavax)
What is Zostavax?
Zostavax is a live attenuated vaccine.
Who can get Zostavax?
It is indicated for prevention of herpes zoster also
known as shingles in patients ages 50 and older. It can be utilized in patients regardless of prior
herpes zoster. Research has shown highest
efficacy in patients ages 60-69; due to supply concerns, ACIP recommends the
vaccine in ages 60 and older.
Who should not get
Zostavax?
Contraindications to the vaccine include pregnancy,
immunodeficiency, anaphylaxis, moderate illness (fever > 101.3F).
Also, it is also important to discontinue antivirals
24hrs prior to vaccination and till 14 days after vaccination.
How is Zostavax
given?
0.65ml subcutaneous injection.
What are Zostavax
side effects?
The most common side effects are injection site reactions
and headache.
Can Zostavax be
given with other vaccines?
Yes, CDC recommends that Zostavax can be
administered with all other live and inactivated vaccines including the
pneumococcal vaccine which is commonly given to older adults. According to the package
insert, a Merck-sponsored, randomized clinical trial determined a reduced
immune response to Zostavax when it co-administered with Pneumovax 23 compared
to individuals who received these vaccines 4 weeks apart.
How effective is the
Zostavax vaccine?
The vaccine helped reduce the incidence of shingles
approximately 50% in patients who received the vaccine. How does Zostavax (shingles vaccine) compare to Varivax (chicken pox vaccine)?
They are both live subcutaneous injection vaccines of the
same virus with Zostavax being 14 times more potent than Varivax. Zostavax is
for older adults (age 60 and older) and Varivax is for children (1 year and
older). The two vaccines cannot be used
in exchange for each other in adults and children.
The dosing in children for Varivax is 0.5ml two doses subcutaneous.
For children ages 1 to 12 years, there should be a
minimum interval of 3 months between doses.
For children ages 13 and older, there should be a minimum
interval of 4 weeks between doses.
How is Zostavax stored?
Live vaccines such as (Zoster,
Varicella, MMR, MMRV) should be stored in the freezer -58°F and +5°F (-50°C and
-15°C).
Other live vaccines such that
are refrigerated at 2° to 8°C (35° to 46°F) include:
rotavirus (Rotarix,
RotaTeq)
yellow fever (YF-Vax)
polio (IPOL,
KINRIX, Pediarix, Pentacel, Quadracel)
tuberculosis
(BCG vaccine)
typhoid
(Vivotif, TYPHIM Vi)
Where can I get more information?
Zostamax [package
insert]. Whitehouse Station, NJ: Merck & Co., Inc.; 2015. Available at: https://www.merck.com/product/usa/pi_circulars/z/zostavax/zostavax_pi2.pdf
Centers for Disease
Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable
Diseases. Hamborsky J, Kroger A, Wolfe S, eds. 13th ed. Washington D.C. Public
Health Foundation, 2015. Available at: http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/varicella.pdf
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