| To whom
should shingles vaccine be given? |
 |
| A single dose of zoster vaccine is
recommended for adults age 60 years and older whether or not they report
a prior episode of herpes zoster. Persons with chronic medical
conditions may be vaccinated unless a contraindication or precaution
exists for their condition. |
|
| Until
CDC publishes its official recommendations for the use of Zostavax(r),
what should I use to guide me? |
|
| CDC has posted the provisional
recommendations of ACIP at
www.cdc.gov/vaccines/recs/provisional/default.htm |
|
| How
effective is the new Zostavax® vaccine in preventing
shingles? |
|
| In clinical trials, vaccine recipients had a 51% reduction in shingles,
less severe illness when shingles did occur, and 66.5% less postherpetic
neuralgia, compared with placebo recipients. During these trials, no
significant safety issues were identified. |
|
| How should Zostavax be stored? |
|
| Zostavax must be stored like varicella
vaccine, frozen at an average temperature of 5°F (-15°C)
or colder until it is reconstituted. Any freezer that has a separate
sealed freezer door and reliably maintains an average
temperature of 5°F or colder is acceptable for storage. The diluent
should be stored separately at
room temperature or in the refrigerator. |
|
| If we inadvertently give a
12-year-old child Zostavax(r) instead of Varivax, what should we do? |
|
| This is a serious vaccine administration
error. The event should be documented, reported to VAERS, and procedures
put in place to prevent this from happening again. Zostavax vaccine
contains about 14 times as much varicella vaccine virus as Varivax. |
|
| Should people who haven't had
chickenpox be vaccinated with zoster vaccine? |
|
| Serologic surveys indicate that almost
everyone born in the United States before 1980 has had chickenpox. As a
result, there is no need to ask patients age 60 years and older for
their varicella disease history or to conduct lab tests for serologic
evidence of prior varicella disease. A person age 60 years or older who
has no medical contraindications, is eligible for zoster vaccine
regardless of their memory of having had chickenpox. |
|
| Can someone who has experienced an
episode of shingles be vaccinated with the zoster vaccine? |
|
| Yes. Shingles vaccine is routinely
recommended for all persons age 60 years and older who do not have
contraindications. |
|
| How soon after experiencing a case of
shingles can a person age 60 years or older receive zoster vaccine? |
|
| The general guideline for any vaccine is
to wait until the acute stage of the illness is over and symptoms
abate.. |
|
| Can you give zoster vaccine to
persons younger than age 60? |
|
| FDA has licensed the vaccine only for
persons age 60 years and older. CDC does not recommend off-label use of
zoster vaccine among persons younger than 60 years. |
|
| How is Zostavax administered? |
|
| The vaccine is administered subcutaneously. Reconstitute using the
diluent provided and administer it immediately after reconstitution to
minimize loss of potency. If the vaccine is not administered within 30
minutes, it must be discarded. |
|
| When reconstituted, the volume of
zoster vaccine is 0.65 mL. Should 0.65 mL or 0.5 mL be administered to
the patient? |
|
| The recommended dose for zoster vaccine
is the fully reconstituted amount, 0.65 mL. |
|
| Is there an upper age limit for
receipt of the zoster vaccine? Local providers are reluctant to give
zoster vaccine to persons age 80-plus years. What educational resource
do you suggest using to encourage use of zoster vaccine with older
adults? |
|
| There is no upper age limit for zoster
vaccine. The incidence of herpes zoster increases with age. It is known
that about 50% of persons living until age 85 years will develop zoster.
When the CDC recommendations are published, there will most likely be
more information about the risks and incidence of zoster. |
|
| People are picking up zoster vaccine
at local pharmacies and transporting it to the physician's office to be
given. Should this vaccine be given? |
|
| Zoster vaccine must be stored at freezer
temperature at all times. If the vaccine has been out of the freezer for
more than 30 minutes, it should not be used unless a state health
department or Merck has authorized its use. |
|
| What do you think about giving zoster
vaccine to nursing home patients? Should healthcare personnel in nursing
homes be tested to see if they have had chickenpox before taking care of
someone who has received zoster vaccine? |
|
| Zoster vaccine can be administered to
anyone age 60 years and older regardless of where they reside, unless
they have a contraindication to vaccination. All healthcare personnel
should ensure they are immune to varicella regardless of the setting in
which they work and regardless of their patients' receipt of zoster
vaccine.. |
|
| Reviewed on 5/08 |
|
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