VARICELLA VACCINE

VARICELLA VACCINe
(var-i-cel'la)
Varivax
Classifications: vaccine, viral;
Therapeutic: viral vaccine

Prototype: Hepatitis B
Pregnancy Category: C

Availability

1350 PFU/vial

Action

A live attenuated vaccine that acts against both chickenpox and shingles, both of which are caused by Varicella zoster infection.

Therapeutic Effect

Effective in protecting healthy children and adults from varicella.

Uses

Vaccination against varicella in individuals ≥12 mo.

Contraindications

Hypersensitivity to any component of the vaccine; history of anaphylactoid reaction to neomycin; individuals with blood dyscrasia, leukemia, lymphomas, bone marrow or lymphatic system malignancies, concomitant immunosuppression therapy; individuals with primary or acquired immunodeficient states; active untreated tuberculosis; any febrile respiratory illness or other febrile infections; pregnancy (category C); children <1 y.

Cautious Use

Acute lymphoblastic leukemia in remission; IgA deficiency; lactation.

Route & Dosage

Varicella Protection
Adult: SC Primary immunization of 0.5 mL followed by 0.5 mL 4–8 wk after first dose, may need to revaccinate 3 mo after initial series if patient fails to seroconvert
Child (12 mo–12 y): SC Single dose of 0.5 mL

Administration

Subcutaneous
  • Reconstitute vaccine with 0.7 mL of supplied diluent; gently agitate the vial to mix. Withdraw entire contents of vial (0.5 mL) into syringe for injection. Change needle on syringe and administer immediately or within 30 min of reconstitution.
  • Give SC into the outer aspect of the deltoid. Exercise caution not to inject IV.
  • Store powder vaccine in frost-free freezer at –15° C (+5° F) or colder. Store diluent separately at room temperature or in the refrigerator.

Adverse Effects (≥1%)

CNS: Headache, fever. Hematologic: Mild thrombocytopenia. Skin: Redness, swelling, or rash at injection site. Other: Herpes zoster infection (rare).

Interactions

Drug: Acyclovir decreases vaccine's effectiveness. It is recommended that yellow fever vaccine be given at least 1 mo apart from varicella or any other live virus vaccine. Avoid salicylates for 6 wk after vaccination to decrease risk of developing Reye's syndrome.

Pharmacokinetics

Onset: Seroconversion approximately 42 d after vaccination. Duration: >5–10 y in healthy children. Distribution: Crosses placenta; distributed into breast milk.

Nursing Implications

Assessment & Drug Effects

  • Withhold vaccine and notify physician if patient has a history of hypersensitivity to neomycin or a current febrile infection.
  • Monitor for signs and symptoms of hypersensitivity (see Appendix F) and administer epinephrine if an anaphylactoid reaction occurs.

Patient & Family Education

  • Avoid use of salicylates (e.g., acetylsalicylic acid) for 6 wk after vaccination, especially with children and adolescents.
  • Notify physician about all adverse reactions (i.e., fever, rash, respiratory illness).

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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