Generic Name: Zoster virus vaccine live (Ola/Merck)
Product Name: Zostavax Powder for Injection
Zostavax is used for the prevention of herpes zoster, commonly known as shingles, in individuals aged > 50 years. Shingles is a virus that infects people who have previously been infected with the varicella (chicken pox) virus. Almost all adults in Australia have had chicken pox, and so almost all have a risk of developing shingles.
Shingles can cause severe pain and usually occurs in people aged > 50 years. It can lead to serious complications, including chronic pain and postherpetic neuralgia (nerve pain resulting from the shingles), which can last for years after the shingles is cured. For some people, the pain is so severe that it interferes with normal activities like walking and sleeping. In people aged ≥ 60 years, Zostavax may be used to reduce the likelihood and severity of these complications of shingles.
Zostavax is not used to treat people who have already had shingles.
For more information on chicken pox and related conditions, as well as some useful videos, see Chicken Pox, Shingles and Postherpetic Neuralgia.
Zostavax boosts immunity to herpes zoster virus, commonly known as shingles, by increasing immunity to varicella zoster virus (chicken pox). Herpes zoster infection only occurs in people who have previously been infected with chicken pox. This includes people who have had very mild episodes of chicken pox (some may not have realised they had the chicken pox) and those who have been immunised to prevent chicken pox.
When a person is immunised or infected with chicken pox virus, their body’s immune system begins producing antibodies to fight off the infection. These antibodies also provide future protection from infection with the disease. Antibodies specific to varicella zoster virus also provide protection against herpes zoster virus.
As the period of time since chicken pox infection increases, the number of antibodies in a person’s system and their immunity to the disease starts to decline. When chicken pox immunity declines, an individual also becomes susceptible to shingles.
Zostavax works by increasing varicella-specific antibodies. This boosts varicella immunity and also provides protection against shingles.
For more information on immunisation, including the childhood immunisation scedule, types of vaccines, preconception screening, as well as some useful videos, see Immunisation.
Zostavax is injected under the skin by a trained doctor or nurse. It is not injected into a vein or muscle. A single injection containing 0.65 mL of vaccine solution is injected.
Zostavax may be given at the same time as another vaccine. However, the doctor will use a separate needle and syringe for each vaccine. Different vaccines will be injected in different places.
The duration of protection from herpes zoster virus following vaccination with Zostavax is unknown beyond four years.
Transmission of varicella infection from individuals who develop a chickenpox-like rash following vaccination has been reported. There are also unconfirmed reports of transmission from individuals who do not develop a chickenpox-like rash following vaccination. Your doctor will assess your risk of transmitting varicella virus to a susceptible individual before vaccinating you.
If you have any queries about the correct way to use Zostavax, please ask your doctor.
Zostavax should not be used under certain conditions. Tell your doctor if you:
- Have any allergies, especially to neomycin or gelatin;
- Have a weakened immune system, for example caused by:
- Cancer, especially leukaemia or lymphoma
- Medicines that suppress your immune system (immunosuppressants);
- A genetic condition;
- Acquired immune deficiency syndrome (AIDS) or human immunodeficiency virus (HIV);
- Have active tuberculosis which is not being treated;
- Are pregnant or planning to become pregnant.
Special care needs to be taken when using Zostavax under certain conditions. Tell your doctor if you:
- Have had a reaction to any varicella-containing vaccine in the past;
- Have any medical problems affecting your health;
- Are planning to become pregnant in the next three months;
- Have a fever;
- Are taking any medicines, including medicines which you buy at the pharmacy or supermarket without a prescription, supplements and herbal preparations.
Zostavax is a Pregnancy Category B2 medication. It is not known whether or not Zostavax is harmful when used in pregnant women, but natural varicella infection is known to cause harm to the foetus. Therefore, Zostavax is not given to pregnant women, and pregnancy should be avoided for 3 months after vaccination.
Zostavax is not not given to women who are breastfeeding as the virus contained in the vaccine may be passed on to the baby being breastfed.
Zostavax is indicated for use in individuals > 50 years of age. It is not given to children.
Zostavax is a Schedule 4 medication.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 Zostavax.
Zostavax is generally well tolerated. Side effects are usually of mild or moderate severity.
Very common side effects are those that occur in more than 10% of people given Zostavax. These include:
Common side effects are those that occur in 1–10% of people given Zostavax. These include:
Uncommon side effects
Some side effects occur with unknown frequency in people given Zostavax. People do not necessarily experience any of these side effects, so do not become alarmed by this list:
- Joint pain;
- Muscle pain;
- Injection site rash;
- Injection site urticaria;
- Swelling of lymph nodes at the injection site;
- Hypersensitivity reactions including anaphylactic reactions;
Allergic (anaphylactic) reaction
Zostavax and other vaccines cause serious allergic reactions called anaphylactic reactions in a very small proportion of people. They usually occur within the first few hours after vaccination. While there is only a small chance of anaphylactic reaction, it is a very serious side effect, which requires immediate medical attention. Contact your doctor immediately or go to the hospital emergency department if you severely experience any of the following symptoms in the hours following vaccination with Zostavax:
- Swelling of the arms or legs, face, eyes, nose, mouth or throat;
- Shortness of breath or difficulty breathing or swallowing;
- A skin rash or hive;
- Itching, especially of the hands and feet;
- Skin redness, especially around the ears;
- Other severe skin reactions;
- Sudden and severe tiredness or weakness.
If you experience any of the listed side effects, or any other symptoms that appear abnormal or unusual, please tell your doctor.
- Zostavax Product Information [online]. St Leonards, NSW: MIMS Online; 1 August 2010 [cited 10 January 2011]. Available from: URL link
- Zostavax Consumer Medicine Information [online]. St Leonards, NSW: MIMS Online; 1 December 2010 [cited 10 January 2011]. Available from: URL link
Diseases treated with Zostavax Powder for Injection:
For further information talk to your doctor.