This vaccine, Zostavax®, is a live attenuated vaccine against varicella zoster virus, and is similar to the varicella Vaccine (Varivax®-Merck).

This vaccine prevents herpes zoster (shingles) and its complications including post-herpetic neuralgia. The varicella zoster virus causes chickenpox. After a chickenpox infection the virus is not eradicated from the body, but lies dormant in nerve tissue. Later it can reactivate and cause herpes zoster, also called shingles. Shingles is usually a one-sided painful rash that follows a particular nerve distribution. Complications can include pain, sometimes longlasting called post-herpetic neuralgia, which can be very severe. Shingles may also be a widespread infection and this is more typical in people with immune problems, like leukemia, lymphoma, or HIV. Shingles can lead to severe complications including pneumonia, encephalitis, blindness, deafness, bacterial infection, and even death. An outbreak of shingles is felt to be related to declining immunity to the virus, and hence this vaccine was developed.

This vaccine is given as a subcutaneous injection usually in the upper arm.

This vaccine is not recommended for people with a history of serious reactions to any component of the vaccine including gelatin and neomycin. This vaccine is also not recommended for the following people: 1) those with immune compromised states including HIV with a CD4+ T lymphocyte count less than 200 cells per microliter; 2) those with cancers that affect immunity like lymphoma and leukemia; 3) those on immune suppressing medicines like steroids; and 4) those with active untreated tuberculosis. This vaccine is not recommended for women who are pregnant, but this is a non-issue in the 60 and over age group.

There can be redness, soreness, or itching at the injection site. Less commonly headache can occur. More severe reactions may be possible.

Individuals with prior severe reactions to this vaccine may not be able to receive another dose. Check with your doctor regarding this issue and for any other contraindications for this vaccine. Also check with your doctor to find out what other ingredients may be in the vaccine, its container, or any diluent in case of allergies or other concerns. Immunization is usually postponed for individuals with a moderate or severe acute illness.

• Prior infection with chickenpox
• Declining immunity to the virus either from age or immune disease or both