Adult Immunization Indications Page 2
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1
2
3Vaccine
Indication/Recommendations
Schedule
Contraindications/Precautions
Dosing/Administration
Varivax
Contraindications
All
a dults
w ithout
e vidence
o f
i mmunity
Give
2
d oses
LIVE
V ACCINE
•
•
•
nd
2
d ose
g iven
4
t o
8
w eeks
Previous
a naphylactic
r eaction
t o
t his
0.5
m L
S UB-‐Q
•
•
•
st
Varicella
NOTE:
e vidence
o f
i mmunity
i s
d efined
a s
w ritten
vaccine
o r
t o
a ny
o f
i ts
c omponents
after
t he
1
Store
i n
F REEZER
•
nd
documentation
o f
2
d oses
o f
v aricella
v accine;
a
h istory
including
n eomycin
o r
g elatin
If
2
d ose
i s
d elayed,
d o
N OT
•
of
v aricella
d isease
o r
h erpes
z oster
b ased
o n
h ealthcare-‐
Pregnancy
o r
t he
p ossibility
o f
repeat
f irst
d ose.
J ust
g ive
To
R econstitute:
•
provider
d iagnosis;
l ab
e vidence
o f
i mmunity;
a nd/or
pregnancy
w ithin
4
w eeks
( 3
m onths
dose
2 .
1.
Withdraw
0 .7
m L
o f
d iluent
i nto
a
birth
i n
t he
U S
b efore
1 980
w ith
t he
f ollowing
per
p ackage
i nsert)
syringe
May
b e
u sed
a s
p ostexposure
•
exceptions:
prophylaxis
i f
g iven
w ithin
5
Pts
o n
h igh-‐dose
i mmunosuppressive
2.
Inject
a ll
o f
t he
d iluent
i n
t he
•
Healthcare
p ersonnel
b orn
i n
t he
U S
b efore
1 980
therapy
syringe
i nto
t he
v ial
o f
l yophilized
days
•
who
d o
n ot
m eet
a ny
o f
t he
a bove
c riteria
s hould
vaccine
Pts
w ith
a ctive
T B
t hat
i s
n ot
t reated
•
be
t ested
o r
g iven
t he
2 -‐dose
s eries.
I f
t esting
3.
Gently
a gitate
t o
m ix
t horoughly.
Pts
w ho
a re
i mmunocompromised
•
st
indicates
t hat
t hey
a re
n ot
i mmune,
g ive
t he
1
If
2
o r
m ore
l ive
v accine
a re
t o
b e
Product
s hould
b e
c lear,
c olorless
because
o f
m alignancy
a nd
p rimary
nd
dose
i mmediately
a nd
g ive
t he
2
d ose
4
t o
8
to
p ale
y ellow
l iquid.
given
( FluMist,
M MR,
V aricella,
acquired
c ellular
i mmunodeficiency,
weeks
l ater
4.
Withdraw
t he
e ntire
c ontents
i nto
Zoster,
a nd/or
Y ellow
F ever)
t hey
including
H IV/AIDS
( although
m ay
Pregnant
w omen
b orn
i n
t he
U S
b efore
1 980
w ho
a
n ew
s yringe
should
b e
g iven
o n
t he
s ame
d ay
consider
v accination
i f
C D4
≥
2 00)
•
do
n ot
m eet
a ny
o f
t he
a bove
c riteria
s hould
e ither
5.
Inject
t he
t otal
v olume
( about
0 .5
OR
s paced
a part
b y
a t
l east
2 8
be
1 )
t ested
f or
s usceptibility
d uring
p regnancy
a nd
mL)
s ub-‐q
i nto
o uter
a spect
o f
days
Precautions
st
if
f ound
s usceptible,
g iven
t he
1
d ose
p ostpartum
upper
a rm
( preferred
s ite)
Moderate
o r
s evere
a cute
i llness
•
before
h ospital
d ischarge,
o r
2 )
n ot
b e
t ested
f or
Note:
R outine
p ost-‐vaccination
If
b lood,
p lasma,
a nd/or
i mmune
•
st
susceptibility
a nd
g iven
t he
1
d ose
p ostpartum
Vaccine
m ust
b e
u sed
w ithin
3 0
m inutes
serologic
t esting
i s
n ot
globulin
w ere
g iven
i n
t he
p ast
1 1
nd
before
h ospital
d ischarge.
G ive
t he
2
d ose
4
t o
8
of
r econstitution
recommended.
months,
s ee
a dditional
A CIP
weeks
l ater.
guidelines
Receipt
o f
s pecific
a ntivirals
•
(acyclovir,
f amciclovir,
o r
valacyclovir)
2 4
h rs
b efore
vaccination,
i f
p ossible;
d elay
resumption
o f
t hese
m eds
f or
1 4
days
a fter
v accination
Zoster
Contraindications
People
a ge
6 0
a nd
o lder
Give
1
t ime
d ose
i f
LIVE
V ACCINE
•
•
•
unvaccinated
r egardless
o f
Previous
a naphylactic
r eaction
t o
t his
0.65
m L
S UB-‐Q
•
•
Package
I nsert
s tates
a nyone
5 0
y ears
o f
a ge
a nd
o lder
previous
h istory
o f
s hingles
o r
vaccine
o r
t o
a ny
o f
i ts
c omponents
Store
i n
F REEZER
•
however
A CIP/CDC
c urrently
o nly
r ecommend
i t
f or
a ges
chickenpox
including
g elatin
a nd
n eomycin
60
a nd
o lder
Primary
c ellular
o r
a cquired
To
R econstitute:
•
If
2
o r
m ore
l ive
v accine
a re
t o
b e
immunodeficiency
1.
Withdraw
t he
e ntire
c ontents
o f
given
(
M MR,
Z oster,
a nd/or
Pregnancy
diluent
i nto
a
s yringe
•
Yellow
F ever)
t hey
s hould
b e
g iven
2.
Inject
a ll
o f
t he
d iluent
i n
t he
on
t he
s ame
d ay
O R
s paced
a part
Precautions
syringe
i nto
t he
v ial
o f
l yophilized
by
a t
l east
2 8
d ays
vaccine
Moderate
o r
s evere
a cute
i llness
•
3.
Gently
a gitate
t o
m ix
t horoughly.
Receipt
o f
s pecific
a ntivirals
•
4.
Withdraw
t he
e ntire
c ontents
i nto
(acyclovir,
f amciclovir,
o r
a
n ew
s yringe
valacyclovir)
2 4
h rs
b efore
5.
Inject
t he
t otal
v olume
s ub-‐q
i nto
vaccination,
i f
p ossible;
d elay
outer
a spect
o f
u pper
a rm
resumption
o f
t hese
m eds
f or
1 4
(preferred
s ite)
days
a fter
v accination
Vaccine
m ust
b e
u sed
w ithin
3 0
m inutes
of
r econstitution
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