Varicella Vaccine

Section 1.1

Midwives may independently prescribe, order and administer this drug.

The varicella vaccine is a live, attenuated vaccine indicated for active immunization against varicella infection. While this vaccine should not be administered during pregnancy, those confirmed as varicella-susceptible in pregnancy should be counselled to report varicella exposure to a health care provider, and advised to receive postpartum varicella vaccination. All pregnant individuals should be evaluated for varicella immunity (prior history of varicella, prior receipt of 2 doses of varicella vaccine, or seroimmunity).

Indications and Clinical Use:

If identified as varicella-susceptible during pregnancy, the varicella vaccine should be offered in the postpartum period.

Contraindications:

Pregnancy; history of anaphylaxis to a prior varicella vaccine or any component of the vaccine; active untreated tuberculosis, immunocompromised as a result of disease or therapy; solid organ transplant recipient; history of chronic inflammatory disease.

Warnings and Precautions:

  • Pregnancy should be avoided for one month following vaccination.
  • Varicella-susceptible individuals who receive RhIg postpartum should wait three months before receiving the varicella vaccine to ensure optimal anti-varicella antibody response. However, if there is a risk of non-compliance in vaccination at a later date, risk of pregnancy, or contracting varicella in the first three months postpartum, the varicella vaccine may be given in the immediate postpartum period so long as serologic testing for varicella is done at one to three months postpartum to assess for immune status. Revaccinate if non-immune.
  • Epinephrine (1:1000) and Diphenhydramine hydrochloride should be available for immediate use in the event of an anaphylactic reaction.

Pregnancy:

Contraindicated

Lactation:

Category L3 – No Data – Probably Compatible

Adverse Events:

Local: pain, redness, swelling. Rates of these events are slightly higher following 2nd dose. Systemic: varicella-like rash, fever. Rates of these events are lower following 2nd dose.

Dosage and Administration:

SC: 0.5 mL

*Reconstituted vaccine should be injected within 90 minutes of reconstitution.