5
Specific Vaccinations
Varicella and Zoster Vaccines
15. VAR should be given to immunocompetent patients without
evidence of varicella immunity (ie, either age-appropriate varicella
vaccination, serologic evidence of immunity, clinician-diagnosed or
verified history of varicella or zoster, or laboratory-proven varicella
or zoster) (SR-M) if it can be administered ≥4 weeks before
initiating immunosuppressive therapy (SR-L).
16. A 2-dose schedule of VAR, separated by >4 weeks for patients
≥13 years and by ≥3 months for patients 1-12 years of age,
is recommended if there is sufficient time prior to initiating
immunosuppressive therapy (SR-L).
17. VAR should NOT be administered to highly immunocompromised
patients, but certain categories of patients (eg, patients with
HIV infection without severe immunosuppression, or a primary
immunodeficiency disorder without defective T cell-mediated
immunity, such as primary complement component deficiency
disorder, or chronic granulomatous disease [CGD]) should receive
VAR, adhering to a 2-dose schedule separated by a 3-month interval
(SR-M).
18. VAR can be considered for patients without evidence of varicella
immunity (defined in recommendation 16) who are receiving long-
term, low-level immunosuppression (WR-VL).*
19. VAR should be administered to eligible immunocompromised patients
as the single antigen product, not varicella vaccine combined with
measles, mumps, and rubella vaccines (MMRV) (SR-L).
20. ZOS should be given to patients ≥60 years of age if it can be
administered ≥4 weeks before beginning highly immunosuppressive
therapy (SR-L).
21. ZOS should be considered for varicella-positive patients (ie,
persons with a history of varicella or zoster infection or who are
VZV seropositive with no previous doses of VAR) 50-59 years
of age if it can be administered ≥4 weeks before beginning
immunosuppressive therapy (WR-L).*
22. ZOS should be administered to patients ≥60 years of age receiving
therapy considered to induce a low level of immunosuppression
(SR-L).
23. ZOS should NOT be administered to highly immunocompromised
patients (SR-VL).
