No

Immune Globulin

Passive immunization of susceptible immunodeficient patients after exposure to varicella; most effective if begun within 96 hours of exposure; there is no evidence VZIG modifies established varicella-zoster infections.

Neoplastic disease (eg, leukemia or lymphoma)

Congenital or acquired immunodeficiency

Immunosuppressive therapy with steroids, antimetabolites or other immunosuppressive treatment regimens

Newborn of mother who had onset of chickenpox within 5 days before delivery or within 48 hours after delivery

Premature ( greater than or equal to 28 weeks gestation) whose mother has no history of chickenpox

Premature (<28 weeks gestation or less than or equal to 1000 g VZIG) regardless of maternal history

One of the following types of exposure to chickenpox or zoster patient(s) may warrant administration:

Continuous household contact

Playmate contact (>1 hour play indoors)

Hospital contact (in same 2-4 bedroom or adjacent beds in a large ward or prolonged face-to-face contact with an infectious staff member or patient)

Susceptible to varicella-zoster

Age <15 years; administer to immunocompromised adolescents and adults and to other older patients on an individual basis

An acceptable alternative to VZIG prophylaxis is to treat varicella, if it occurs, with high-dose I.V. acyclovir

Age is the most important risk factor for reactivation of varicella zoster; persons <50 years of age have incidence of 2.5 cases per 1000, whereas those 60-79 have 6.5 cases per 1000 and those >80 years have 10 cases per 1000

C

Not for prophylactic use in immunodeficient patients with history of varicella, unless patient's immunosuppression is associated with bone marrow transplantation; not recommended for nonimmunodeficient patients, including pregnant women, because the severity of chickenpox is much less than in immunosuppressed patients; allergic response to gamma globulin or anti-immunoglobulin; sensitivity to thimerosal; persons with IgA deficiency; do not administer to patients with thrombocytopenia or coagulopathies

VZIG is not indicated for prophylaxis or therapy of normal adults who are exposed to or who develop varicella; it is not indicated for treatment of herpes zoster. Do not inject I.V.

1% to 10%: Local: Discomfort at the site of injection (pain, redness, edema)

<1%: Malaise, headache, rash, angioedema, GI symptoms, respiratory symptom, anaphylactic shock

Decreased effect: Live virus vaccines (do not administer within 3 months of immune globulin administration)

Refrigerate at 2°C to 8°C (36°F to 46°F)

The exact mechanism has not been clarified but the antibodies in varicella-zoster immune globulin most likely neutralize the varicella-zoster virus and prevent its pathological actions

High risk susceptible patients who are exposed again more than 3 weeks after a prior dose of VZIG should receive another full dose; there is no evidence VZIG modifies established varicella-zoster infections.

VZIG dose based on weight:

0-10 kg (0-22 lb): 125 units; 1 vial

10.1-20 kg (22.1-44 lb): 250 units; 2 vials

20.1-30 kg (44.1-66 lb): 375 units; 3 vials

30.1-40 kg (66.1-88 lb): 500 units; 4 vials

>40 kg (>88 lb): 625 units; 5 vials

Administer entire contents of each vial

No information available to require special precautions

No effects or complications reported

Be aware of adverse reactions

Administer as soon as possible after presumed exposure; do not inject I.V.; administer by deep I.M. injection into gluteal muscle or other large muscle; administer entire contents of each vial

Injection: 125 units of antibody in single dose vials