ZOSTAVAX® Vaccine Administration Alert
|- Attention all doctors -|
|Date: 27/02/2017||Contact telephone number: 1300 232 272 (24 hours/7 days)|
ZOSTAVAX® VACCINE ADMINISTRATION ALERT
- Use of shingles vaccine (Zostavax®) when contraindicated has resulted in a death in Australia.
- DO NOT administer Zostavax® to patients with severe immunocompromise.
Take a detailed medical and medication history prior to vaccination.
Conditions that would contraindicate zoster vaccination include:
- Anaphylaxis following a previous dose of any VZV-containing vaccine (either zoster or varicella vaccine), or anaphylaxis following any vaccine component (including gelatin or neomycin).
Primary or acquired immunodeficiency
- Current haematologic neoplasms: leukaemias, lymphomas, myelodysplastic syndromes
- Post-transplant: solid organ (on immunosuppressive therapy)
- Haematopoietic stem cell transplant (within 24 months)
- Immunocompromised due to primary immunodeficiency
- Symptomatic HIV or HIV with CD4 count of ≤200 per μL
- Other significantly immunocompromising conditions
Immunosuppressive therapy (current or recent)
- Chemotherapy or radiotherapy. Wait at least 6 months after the end of treatment and patients are demonstrated to be in remission.
- Corticosteroids (short-term high dose, long-term lower dose). See table below:
- All biologics and most disease-modifying anti-rheumatic drugs (DMARDs). See table below.
(This is not a complete list of all immunosuppressive medications. If on more than one agent or if any doubt do not administer Zostavax® and seek specialist advice about its use.)
|Drug Group||Some examples||Comments re Zostavax® use|
|Anti-TNF||Etanercept, Infliximab, Adalimumab||
Zostavax can be used 1 month prior to treatment initiation or 12 months post treatment cessation.
|Azathioprine, Methotrexate, 6-Mercaptopurine||
Contraindicated if >3.0mg/kg/day azathioprine, or >0.4mg/kg/week methotrexate, or >1.5mg/kg/day 6-mercaptopurine.
Zostavax can be used 1 month prior to treatment initiation or 3 months post treatment cessation.
|Corticosteriod||Prednisolone||Complex – see The Australian Immunisation Handbook section 3.3.3.|
Zostavax can be used 1 month prior to treatment initiation or 3 months post treatment cessation
Urgently seek specialist advice if Zostavax® is given to a person with severe immunocompromise.
For more information see http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home
Dr Ann Koehler - Director, Communicable Disease Control Branch
For all enquiries please contact the CDCB on 1300 232 272 (24 hours / 7 days)
Public – I3-A2
Download the official health alert here (PDF)