Infectious Disease Book

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Varicella Zoster Virus VaccineAka: Herpes Zoster Virus Immunization, Zostavax

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  1. Indications
    1. Prevention of Shingles in age 60 years or older
  2. Contraindications
    1. Human Immunodeficiency Virus
    2. Immunocompromised Conditions
    3. Recent Systemic Corticosteroid use
    4. Concurrent acute febrile illness (Fever >101.3 F)
  3. Cost
    1. Approximate: $186
    2. Injection and drug are now covered under Medicare Part D
  4. Dose:
    1. Zostavax 0.65 ml SQ for one dose
  5. Precautions
    1. Live, attenuated varicella-zoster virus vaccine
    2. Virus load injected is 14 times greater than Varivax
  6. Adverse Effects
    1. Local inflammation at injection site (33%)
    2. Chicken Pox or Shingles-type rash is uncommon
  7. Efficacy
    1. Immunity appears to last at least 4 years
    2. Decreases Herpes Zoster Incidence by 50%
      1. Occurs in 3.3% of unvaccinated patients
      2. Occurs in 1.6% of vaccinated patients
      3. Number Needed to Treat to prevent 1 case: 60
    3. Reduces Postherpetic Neuralgia by 66%
      1. Occurs in 0.4% of unvaccinated patients
      2. Occurs in 0.24% of vaccinated patients
      3. Number Needed to Treat to prevent 1 case: 360
  8. References
    1. DeYoung (2007) Am Fam Physician 75:1843
    2. Hornberger (2006) Ann Intern Med 145:317
    3. Oxman (2005) N Engl J Med 352:2271

Zostavax (C1720919)

ConceptsPharmacologic Substance (T121) , Immunologic Factor (T129)
EnglishZostavax
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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