Immunization Schedule, Adults (cont.)
Varicella-zoster virus (VZV) is a member of the herpesvirus family. It can cause either chickenpox (varicella) or herpes zoster (shingles). Chickenpox is a common childhood disease that tends to be mild. However, it can be serious when occurring during adulthood. The virus is spread from person to person through the air or by contact with fluid from chickenpox blisters. The virus causes a rash, itching, fever, and tiredness. A person who previously had chickenpox can develop shingles years later. This happens because the VZV infects part of certain nerves. The virus "sleeps" there and may become reactivated in the future.
- Who gets the vaccine: susceptible adults and adolescents; susceptible health-care workers; susceptible family contacts of people with weakened immune systems; those at high risk for exposure such as day-care employees, employees in institutional settings such as prisons, college students, and military personnel; and international travelers.
- Females of childbearing age (regardless of age and year of birth) without evidence of immunity should be immunized. Women should not receive varicella while pregnant or may if they may become pregnant within
four weeks of receiving the vaccine.
- When given: For those younger than 13 years of age, one dose is needed. If older than 13, two doses are given four to eight weeks apart.
- Side effects: pain, swelling, redness at site of injection; a small rash may develop that can spread chickenpox to others; and chickenpox may develop years later, although less severe than the naturally occurring type. Avoid this vaccine if you have had a previous reaction to gelatin or the antibiotic neomycin or had a severe reaction, if you are pregnant or anticipate being pregnant in one month, if you have untreated, active tuberculosis, or if you have a weakened immune system (including HIV). Breastfeeding women may take the vaccine. Aspirin-containing products should be avoided for six weeks after the vaccine to avoid the rare risk of Reye syndrome (rapid liver failure, brain function abnormalities; 30% death rate).
Gregory L Walker, MD, FACEP, Ped EM
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