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| VARICELLA VACCINE
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What
is the schedule?
It is to be given subcutaneous over left arm or thigh. It is given
at 12-15 months of age. In children < 13 years, only one dose
is required. In children > 13 years and adults, 2 doses are given
at 6-8 weeks interval. Immuno-compromised patients need 2 doses
irrespective of age.
What
are the side effects?
It is a very safe vaccine. Local side effects seen include pain,
redness, swelling in <5% of vaccines. Systemic side effects like
fever are rare. 3-7% of vaccines can develop varicella like rash,
which are very mild with rapid recovery. It can occur within 6 weeks
of vaccination.
What
are the contraindications to Varicella vaccine?
Firstly it is not indicated in those who have definite history of
chickenpox in the past. It is contraindicated in-patients with neomycin
hypersensitivity as the vaccine contains traces of neomycin. It
is contraindicated in patients with immunodeficiency including symptomatic
HIV and in children with acute leukemia on chemotherapy.
For
patients with leukemia in remission, chemotherapy should be withheld
for at least 2 weeks before and after the first dose of vaccine.
Similarly patients on high dose of long-term steroids should be
given the vaccine when steroids are temporarily withheld for at
least 2 weeks before and after vaccine.
It
is contraindicated during pregnancy and in fact pregnancy should
be avoided for at least 6-8 weeks after vaccination.
What
is herpes zoster?
Varicella and herpes zoster are manifestations of the same virus
i.e. varicella virus. When a person comes in contact with the virus
for the first time, he develops chickenpox. Even when he recovers,
the virus remains latent in the nerves for years. In 15-20% of them,
the virus is able to spread albeit locally along the nerve root
causing herpes zoster. This occurs due to natural fading of immunity
and hence occurs after the age of 40-50 years.
Herpes
zoster, though usually a benign disease lasting for 7-10 days can
lead to complications. Firstly, it can lead to pain, which can go
on for months to years. Secondly, if it involves the face, it could
also involve the eyes and unless one takes proper precaution, this
can lead to permanent damage to vision. Lastly, herpes zoster if
it occurs in immuno-compromised patients like HIV, it can lead to
complications like pneumonia and brain damage.
Can
herpes zoster be prevented?
Yes, by giving varicella vaccine before chickenpox develops. As
seen, early herpes zoster occurs only after one contracts chickenpox
virus and develops initially. When one takes chickenpox vaccine,
one prevents contact with wild virus and hence prevents both chickenpox
and herpes zoster.
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