NSW Health GP Alert: Zostavax Contraindications

28 February 2017

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  1. Zostavax is contraindicated in patients who are immunocompromised
  2. Administration where contraindicated, has resulted in a death in Australia
  3. Do not administer Zostavax to patients who are immunocompromised. If in doubt seek advice from a specialist or the NSW Immunisation Specialist Service on 1800 679477

Zostavax contains live attenuated varicella-zoster virus, containing 14 times more virus than childhood varicella vaccines. Administration to people with severe immunocompromise risks disseminated disease from the vaccine virus. In addition to being contraindicated for those with previous anaphylaxis to the vaccine or its components, it is vital all GPs are aware of the following contraindications, which include but are not limited to:

  • Haematological or generalised malignancies (including those not on treatment): e.g. lymphoma, acute or chronic leukaemia, Hodgkin’s disease
  • Solid organ or bone marrow transplant recipients (with exceptions as advised by specialists)
  • HIV/AIDS (except as advised by specialist) or other congenital/acquired immunodeficiencies
  • Current or recent high-dose systemic immunosuppressive therapy: e.g. chemotherapy, radiation therapy, oral corticosteroids, disease modifying anti-rheumatic drugs
  • Guide to safe doses of immunosuppressive therapy for Zostavax administration:

If there is inadvertent administration:

  • Urgently contact the treating specialist or infectious disease specialist for advice on use of antivirals.
  • Alternately, call the NSW Immunisation Specialist Service during business hours on 1800 679 477

Further Information: