VARIVAX VACCINE (varicella virus vaccine live/pf)

Drug overview for VARIVAX VACCINE (varicella virus vaccine live/pf):

Generic name: VARICELLA VIRUS VACCINE LIVE/PF (VAR-i-SEL-a)
Drug class: Varicella Vaccines
Therapeutic class: Biologicals

Varicella virus vaccine is a live, attenuated virus vaccine that contains varicella zoster virus (VZV) of the Oka/Merck strain and is used to stimulate active immunity to varicella (chickenpox). Varicella virus vaccine is commercially available in the US as a monovalent vaccine (Varivax(R)) and a fixed-combination vaccine containing measles, mumps, rubella, and varicella antigens (MMRV; ProQuad(R)). Other varicella vaccines may be available in other countries (e.g., Oka/Biken or Oka/RIT strains) that are similar, but not identical, to the Oka/Merck strain.

Varicella virus vaccine live is used to stimulate active immunity to varicella (chickenpox). Varicella virus vaccine live is commercially available as a single-antigen vaccine (Varivax(R)) for use in adults, adolescents, and children 12 months of age or older and as a fixed-combination vaccine containing measles, mumps, rubella, and varicella antigens (MMRV; ProQuad(R)) for use in children 12 months through 12 years of age. MMRV (ProQuad(R)) contains the same potency of measles, mumps, and rubella antigens as commercially available measles, mumps, and rubella virus vaccine live (MMR) and contains a slightly higher potency of varicella antigen than the single-antigen varicella vaccine (Varivax(R)).

The US Public Health Service Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the Infectious Diseases Society of America (IDSA) recommend universal immunization against varicella with 2 doses of a vaccine containing varicella virus vaccine live for all susceptible, healthy children 12 months through 12 years of age unless the vaccine is contraindicated. The ACIP, AAP, AAFP, IDSA, American College of Obstetricians and Gynecologists (ACOG), and American College of Physicians (ACP) also recommend universal immunization against varicella with 2 doses of varicella virus vaccine live for all adolescents and adults 13 years of age or older without evidence of immunity, unless the vaccine is contraindicated. These experts state that special consideration should be given to use of varicella virus vaccine live in susceptible adults who have close contact with individuals who are at high risk for severe varicella (e.g., health-care personnel and family contacts of immunocompromised individuals) and susceptible adults and adolescents who are at high risk for exposure or transmission of the disease (e.g., teachers of young children, child-care employees, residents and staff members of institutional settings including correctional institutions, college students, military personnel, those living in households with children, non-pregnant women of childbearing age, international travelers).

Varicella virus vaccine live also has been used for postexposure vaccination+ in susceptible individuals and for outbreak prevention and control in certain settings. The ACIP states that individuals have evidence of immunity to varicella if there is written documentation of age-appropriate vaccination (one vaccine dose in preschool children 12 months of age or older or 2 doses in school-aged children, adolescents, and adults), they were born in the US before 1980 (US birth before 1980 should not be considered evidence of immunity for health-care providers and pregnant women), they have a history of herpes zoster based on a diagnosis by a health-care provider, or there is laboratory evidence of immunity or laboratory confirmation of varicella infection. In addition, the ACIP states that individuals with a history of typical varicella disease based on a diagnosis or verification of such history by any health-care provider (e.g., school or occupational clinic nurse, nurse practitioner, physician assistant, clinician) can be considered to have evidence of immunity to varicella.

For those reporting a history of or presenting with atypical and/or mild varicella, health-care providers should seek either an epidemiologic link to a typical varicella case (e.g., case occurred in the context of an outbreak or patient had household exposure to varicella in the previous 3 weeks) or evidence of laboratory confirmation performed at the time of acute disease; when such documentation is lacking, individuals should not be considered as having a valid history of varicella since other diseases may mimic mild, atypical varicella.