Varivax Special Precautions

Family History of Immunodeficiency: Vaccination should be deferred in individuals with a family history of congenital or hereditary immunodeficiency until the individual's immune status has been evaluated and the individual has been found to be immunocompetent.
Use in HIV-Infected Individuals: The Advisory Committee on Immunization Practices (ACIP) has recommendations on the use of varicella vaccine in HIV-infected individuals.
Risk of Vaccine Virus Transmission: Post-marketing experience suggests that transmission of varicella vaccine virus (Oka/Merck) resulting in varicella infection including disseminated disease may occur between vaccine recipients (who develop or do not develop a varicella-like rash) and contacts susceptible to varicella including healthy as well as high-risk individuals.
Due to the concern for transmission of vaccine virus, vaccine recipients should attempt to avoid whenever possible close association with susceptible high-risk individuals for up to six weeks following vaccination with VARIVAX. Susceptible high-risk individuals include: Immunocompromised individuals; Pregnant women without documented history of varicella or laboratory evidence of prior infection; Newborn infants of mothers without documented history of varicella or laboratory evidence of prior infection and all newborn infants born at <28 weeks gestation regardless of maternal varicella immunity.
Immune Globulins and Transfusions: Immunoglobulins (IG) and other blood products should not be given concomitantly with VARIVAX [see Immune Globulins and Transfusions under Interactions]. These products may contain antibodies that interfere with vaccine virus replication and decrease the expected immune response.
The ACIP has specific recommendations for intervals between administration of antibody-containing products and live virus vaccines.
Salicylate Therapy: Avoid use of salicylates (aspirin) or salicylate-containing products in children and adolescents 12 months through 17 years of age for six weeks following vaccination with VARIVAX because of the association of Reye syndrome with salicylate therapy and wild-type varicella infection [see Salicylates under Interactions].
Use in Children: No clinical data are available on safety or efficacy of VARIVAX in children less than 12 months of age.
Use in the Elderly: Clinical studies of VARIVAX did not include sufficient numbers of seronegative subjects aged 65 and over to determine whether they respond differently from younger subjects.