Varivax Refrigerated Powder for Injection

Generic Name: Varicella zoster vaccine, live attenuated
Product Name: Varivax Refrigerated Powder for Injection

Indication

Varivax Refrigerated Powder for Injection is a vaccine which protects against chicken pox, also known as the varicella virus. It can be used by adults and children aged ≥ 12 months. The vaccine is especially beneficial for:

• Non-immune adults (i.e. those who have not had chicken pox or been vaccinated against it before), particularly those who work in occupations where there is a high risk of exposure to the virus (e.g. healthcare, education or childcare);
• Non-immune parents of young children;
• Non-immune adults and children who live in the same house as someone with an immune system deficiency, when the immunodeficient person has no history of chicken pox (i.e. has not been vaccinated for or experienced infection with chicken pox).

For more information on chicken pox and related conditions, as well as some useful videos, see Chicken Pox, Shingles and Postherpetic Neuralgia.

Action

Varivax contains a weakened form of the chicken pox or varicella virus. When the vaccine enters a person’s body, it causes a slight infection. The infection is usually not strong enough to cause the person to become ill or show symptoms of chicken pox. However, it is strong enough for the person’s immune system to register the disease. The immune system then begins to fight against the disease by producing antibodies which attack the varicella virus. These antibodies fight the slight infection caused by the vaccine and then remain in the person’s body, providing protection against future chicken pox infection.

Dose advice

Dose information

Storage

Varivax is usually stored at the doctor’s office. However, if you need to store Varivax, ensure that it is kept refrigerated (2–8^oC). Do not freeze. Do not keep it in the door of the fridge. Keep out of reach of children. Keep the vaccine in the original packaging, protected from exposure to light. Do not keep for longer than 24 months.

Administration site

Varivax is administered as an injection under the skin. It should not be injected into the vein. Usually the vaccine is injected into the skin of the upper arm, though the upper thigh is sometimes used.

Dose

The recommended dose varies depending on age:

• Children aged 1–12 years: Children should receive a single injection of 0.5 mL of reconstituted Varivax solution;
• Adolescents and adults aged > 13 years: Adolescents and adults require two injections of 0.5 mL of reconstituted Varivax solution. The injections should be administered 4–8 weeks apart.

Important information

Do not use the medicine if it has passed its expiry date or if the packaging is damaged.

Following vaccination, you may be able to pass on the infection to other people who have not been vaccinated. Try to avoid those who are particularly susceptible, including pregnant women, people with immune system disorders and young babies.

It is important that women do not fall pregnant for at least three months after being vaccinated, as it is not known whether Varivax can harm your foetus. If you are sexually active, ensure you are using appropriate contraception. Your doctor can advise about and prescribe a range of contraceptive methods.

Avoid using aspirin or other salicylate-containing medicines or foods for at least six weeks after vaccination. These medicines can cause a very serious and sometimes fatal illness which destroys the liver and brain, called Reye’s syndrome.

Tell your doctor you have been vaccinated with Varvivax before taking any immunoglobulin products in the two months following vaccination.

Report to your doctor immediately if you feel unwell after being vaccinated with Varivax.

Varivax may cause dizziness and/or lightheadedness and negatively affect your ability to drive a car or operate machinery.  Monitor you reaction after being vaccinated and ensure you are not dizzy or lightheaded before driving.

If you have any queries about the correct way to use Varivax, please askyour doctor.

Contraindications

Varivax should not be used under certain conditions. Tell your doctor if you:

• Are allergic to any medicines or foods;
• Are pregnant or plan to fall pregnant in the next three months;
• Have an immune disorder which prevents your immune system working as well as it should. Immune disorders can be caused by:
  • A genetic condition, which is passed on in your family;
  • A blood disorder;
  • Cancer;
  • Medication use, including anti-cancer medications and corticosteroids;
  • Radiation therapy;
  • Acquired immune deficiency syndrome (AIDS);
• You are sick and have a fever. Varivax cannot be administered until the fever has gone;
• Active tuberculosis.

Precautions

Special care needs to be taken when using Varivax under certain conditions. Tell your doctor if you:

• Have received another vaccine in the past month;
• Have received a blood or plasma transfusion in the past five months;
• Have received immunoglobulin in the past five months;
• Are breastfeeding;

Drug interactions

Many different medications interact with each other, meaning that when they are taken at the same time, one medicine may alter the effects of the other medicine. Sometimes taking two medicines together can cause dangerous reactions or stop the medicines from working. For this reason, Varivax should not be taken by people who use some medicines. Tell your doctor about all the medicines you use (including medicines you buy at the supermarket or pharmacy without a prescription, herbal preparations and supplements). Your doctor will assess whether or not it is safe for you to take these medicines at the same time as Varivax.

Medicines which contain salicylates (including aspirin) and those which suppress the immune system should not be used in combination with Varivax. Do not take these medications for at least six weeks after being vaccinated.

Pregnancy

Varivax is a Pregnancy Category B2 medication. It should not be used by pregnant women, women who think they may be pregnant, or women who are planning to fall pregnant within three months.

Breastfeeding

There is no evidence showing whether or not the varicella virus is passed on in human milk. However, some viruses are transmitted in this manner. Breastfeeding women should therefore not be vaccinated with Varivax. Tell your doctor if you are breastfeeding.

Children

Varivax can be used by children who are ≥ 12 months of age.

Schedule

Varivax is Schedule 4.¹

Common side effects

All medicines have side effects. Most commonly the side effects are minor; however, some can be more serious. Usually the benefits of taking a medication outweigh the associated side effects. Your doctor would have considered these side effects before injecting you with Varivax.

The side effects of Varivax are usually mild and clear up within a few days, without needing treatment from the doctor. However, some side effects are more serious and will need to be treated by the doctor.

Mild side effects

Mild side effects of Varivax are those which are minor and clear up within a few days, without treatment from a doctor. They are mainly disorders of the injection, and include:

• At the injection site (the skin into which the vaccine was injected):
  • Pain;
  • Soreness;
  • Swelling;
  • Itching;
  • Redness;
  • Bruising;
  • Numbness;
  • Stiffness or a hard lump.
• Irritability;
• Swollen glands, typically located in the neck, armpit or groin;
• Chicken pox-like rash on the body or at the injection site.

More serious side effects

Sometimes Varivax causes more serious side effects which require treatment from the doctor. People do not necessarily experience any of these side effects, so do not become alarmed by this list:

• Skin rash, itchiness, or other severe skin reactions;
• Pinkish, itchy swellings on the skin, also called hives or nettle rash;
• Swelling of the face (including lips, mouth, throat or neck). This swelling may cause difficulty in swallowing or breathing;
• Seizures or fits;
• Severe skin conditions, including skin infections and shingles, an infection which causes skin blisters and severe pain;
• A drooping eyelid or sagging muscles on one side of the face. This may be a condition known as Bell’s palsy;
• Pneumonia or pneumonitis (characterised by fever and/or chills, difficulty breathing, cough, phlegm, wheezing);
• Encephalitis (characterised by headache and fever, progressing to hallucinations, confusion, paralysis of part or all of the body, behavioural disturbances, abnormal speech and eye movements, stiff neck, and sensitivity to light).

Contact your doctor immediately if you experience any of these side effects after your chicken pox vaccine.

If you experience any of the listed side effects, or any other symptoms that appear abnormal or unusual, please tell your doctor.

References

1. Varivax Product Information [online]. St Leonards, NSW: MIMS Online; 26 June 2008 [cited 15 February 2011]. Available from: [URL link]
2. Varivax Consumer Medicine Information [online]. St Leonards, NSW: MIMS Online; June 2008 [cited 15 February 2011]. Available from: [URL link]

Diseases treated with Varivax Refrigerated Powder for Injection:

• Chicken Pox (Varicella Zoster Virus)

For further information talk to your doctor.