Bulletin No. 11
July 14, 1998
Varicella Vaccine Now Available Through Alaska Immunization Program
B
ACKGROUND
Varicella (chickenpox) is a highly communicable disease in children, adolescents, and adults caused by the varicella-zoster virus. Although generally a benign, self-limiting illness, it may be associated with serious complications (e.g., bacterial superinfection, pneumonia, encephalitis, Reye syndrome), including death.
In the United States each year, 50 to 100 children die from varicella, and up to 10,000 persons require hospitalization. Hospitalization rates are approximately 2-3/1,000 cases among healthy children, and 8/1,000 cases among adults. Death occurs in approximately 1 in 60,000 cases. Only 20% of persons who die or are hospitalized have an underlying disease.
1
Secondary attack rates among susceptible household contacts of persons with varicella are as high as 90%.
2
The majority of cases occur in children less than 15 years of age. More than 90% of adults have antibodies to varicella.
V
ACCINE
Varivax®, the only currently licensed varicella vaccine, is a live attenuated virus vaccine. It provides 70-90% protection against infection with varicella-zoster virus, and 95% protection against severe disease. Immunity appears to be long-lasting, and is probably permanent in the majority of vaccinees.
2
Varivax® may be given simultaneously with MMR and all other vaccines. However, if varicella and MMR vaccines are not administered at the same time, they should be separated by at least 30 days. Varicella vaccine is recommended for all children 12 to 18 months of age, and for other susceptible persons. (Table 1)
Table 1: Dosage and Administration of Varivax®
|
Age at Administration
|
Dosage
|
# Doses
(Schedule)
|
|
12 mos-12 yrs
|
0.5 mL, SC
|
1 dose
|
|
> 13 yrs
|
0.5 mL, SC
|
2 doses
(4-8 wks apart)
|
Varicella vaccine is very safe. About 20% of vaccine recipients will have minor injection site complaints such as pain, swelling or redness. Less than 5% of recipients develop a localized or generalized varicella-like rash 5-26 days after vaccination. These rashes have an average of 2-5 lesions, and may be maculopapular rather than vesicular. Fever following receipt of varicella vaccine is uncommon.
S
TORAGE
and H
ANDLING
R
EQUIREMENTS
This vaccine is extremely fragile. Varivax® must remain frozen at an average temperature of -15
°
C (+5
°
F) or colder. Any freezer (including frost-free) that reliably maintains an average temperature of -15
°
C (+5
°
F) and has a separate sealed freezer door is acceptable for storing Varivax®. The vaccine may be stored at a refrigerator temperature of 2-8
°
C (36-46
°
F) for up to 72 continuous hours prior to reconstitution. Vaccine stored at 2-8
°
C (36-46
°
F) which is not used within 72 hours of removal from -15
°
C (+5
°
F) storage must be discarded. Contact the Immunization Program for specific disposal instructions.
O
RDERING
P
ROCEDURES
Because of Varivax® strict storage and handling requirements, the manufacturer requires that each medical facility supplied with the vaccine must be certified to provide varicella vaccine. You may obtain the required certification forms from Dorothy Batten at (907) 269-8018. After a facility is certified, the vaccine is available to providers at no charge and may be ordered for a 3-4 month period using the standard Quarterly Vaccine Order Form. This form may
be mailed or faxed to the Immunization Program at (907) 561-0847. Orders may be placed after July 27, with delivery scheduled to begin after August 1. Please allow several weeks for initial order processing and delivery.
|
Important Note - Unlike other vaccines available through the Immunization Program:
·
Varivax® will be shipped to certified providers directly from the manufacturer.
·
You will be unable to pick up this vaccine at the Alaska Immunization Program Office.
|
Q
UESTIONS
?
If you have questions regarding ordering Varivax®,call Dorothy Batten (269-8018) or Roland Warren (269-8019). For technical assistance, please call Ken Browning at 269-8015.
References:
1 Centers for Disease Control and Prevention, National Immunization Program Website
www.cdc.gov/nip.
2 Atkinson W, Furphy L, Humiston S, Pollard B, Nelson R, Wolfe, S. Epidemiology and Prevention of Vaccine-Preventable Diseases: The Pink Book. (Atlanta, GA: Centers for Disease Control and Prevention, 1997).
|
