Uses and Side Effects of Zostavax

By Brooks

The same virus that is responsible for causing chickenpox in children is responsible for causing herpes zoster in persons of 50 years old and above. This virus is called varicella which when active in adults leads to shingles or herpes zoster. Zostavax vaccine is a live vaccine which operates by preventing shingles. This vaccine was developed by Merck and Co. and for the past years it has been shown to greatly reduce the incidents of herpes zoster. The zostavax vaccine is just a larger than normal dose of chickenpox vaccine. Since both are caused by same virus. Zostavax operates by simply exposing you to a little quantity of live virus thereby forcing your body to develop immunity to this disease. Zostavax vaccine is unable to treat and cure an active infection that has already developed in the body. It should be noted that zostavax would not also treat nerve pain caused by shingles. A review did conclude that herpes zoster vaccine is very effective in completely preventing herpes zoster and this protection can last for a period of three years. Up to then, the need for revaccination has not yet been defined. In May 2006, the zostavax vaccine was approved and licensed by the U.S Food and Drug Administration. This drug was approved by the FDA only for individuals aged from 50 years respecting the following conditions;

  • Has never had any life-threatening allergic reaction to gelatine or any other component of the herpes zostavax vaccine;
  • Does not have a very weak immune system due to diseases like AIDS or medications like dulera;
  • Does not have any history of cancer which affects the bone morrow;

The zostavax vaccine is very safe. Only a few percent of people develop a mild form of chickenpox with about 5 blisters around the injection site without fever as one of the zostavax side effects. After all, blisters are harmless and temporal. Diarrhea and skin rash can come as one of zostavax side effects. More to that, amongst zostavax side effects is joint and muscle pain.The Zostavax vaccine contains a minimum of 19,400 plaque-forming units. It is injected under the skin in the upper arm.

Important information

Never receive zostavax if you are;

  • Pregnant;
  • Having active untreated tuberculosis;
  • Having a weak immune system;
  • Having cancer that affects bone marrow; and
  • Having a history of allergic reaction to gelatine.

You can receive a zostavax vaccine if you have minor cold. But you have to wait until you get better in cases of severe illnesses like tuberculosis before taking zostavax.

It should be noted that being infected to herpes zoster is much dangerous than what results after administration of the vaccine. Nevertheless, just like any other drug there exist zostavax side effects but the risk of serious side effects of zostavax is extremely low. Itching, redness, warmth, swelling, pain, headache and bruising are zostavax side effects.

To make sure zostavax is safe for you, keep your doctor informed of any of the following;

  • Never had chickenpox before;
  • Received any live vaccine within the past 4 weeks; and
  • A history of allergic reaction to any live vaccines.

This drug is administered by a qualified doctor as a single 0.65-mL dose subcutaneously. More precisely at the deltoid region of the hand. There exist other drugs capable of affecting zostavax. A reason why you should tell your doctor about all the previous drugs you were prescribed to take together with those you are taking. This drugs include herbal products, vitamins, and drugs prescribed by other doctors. It is recommended by all to avoid pregnancy 3 months after consumption of zostavax vaccine. Make sure you consult your doctor if you are a breastfeeding mother before taking this drug.

Never receive a second zoster vaccine if you have already experienced a life-threatening allergic reaction after you had the first shot. Make sure you track and keep a record of all the side effects of zostavax after receiving it. This would be of great importance if you ever want to receive a booster dose for you will have to tell your doctor of the previous shots caused by any side effects.

Zostavax should not be used for primary prevention of varicella infection. It should be noted that vaccination with zostavax does not mean protection of all vaccine recipients.

Indications and Usage for Zostavax

The zostavax weakened virus vaccine specified for the inhibition of herpes zoster. This drug is not indicated for the proper handling of postherpetic neuralgia.

Zostavax dosage and administration

Its recommended dose and schedule

Always administer the drug according to medical prescription by a medical practitioner. Generally, zostavax is administered as a single 0.65 mL dose under the skin of the deltoid region of the upper arm. It should never be injected intramuscularly or intravascularly.  In doing this, only sterile syringes free of antiseptics, preservatives and detergents for each injection or reconstitution of zostavax should be used. This is because preservatives and detergents might possibly easily inactivate the vaccine’s virus.

Preparation for administration

Zostavax is at all times preserved frozen and should be re-formed immediately after removal from the freezer. Its diluent should be specially stored separately at room temperature. For reconstitution and administration of zostavax vaccine, make sure separate sterile needles are used. Use only the diluent supplied in reconstituting the vaccine. Start by withdrawing the entire content of the diluent into a syringe. The diluent should be slowly injected in the syringe in to the vial of lyophilised vaccine after which you gently agitate to mix. This is done slowly aimed at avoiding excessive foaming. When zostavax is reconstituted, it is a semi-hazy to translucent, off-white to pale yellow liquid. After withdrawing the whole contents of re-formed vaccine into a syringe, inject the entire volume beneath the skin. Immediately after reconstitution, the drug should be administered in order to minimise loss of potency. If the reconstituted vaccine is not used within 30 minutes, it should immediately be discarded. Never freeze the reconstituted vaccine. All needles should be properly disposed and should not be recapped.

Dosage forms and strengths

This drug is a lyophilised preparation of live varicella-zoster virus which is to be reconstituted with sterile diluent aimed at obtaining a single dosage with a minimum of 19,400 plaque forming units. This happens when it is stored at room temperature for about 30 minutes.



Zostavax should on no occasion be administered to persons with anantiquity of anaphylactic reaction to gelatine and other components of the vaccine.

Immuno suppression

Never administer zostavax to any individual with antiquity of acquired or primary immunodeficiency states amongst which are lymphomas of any type, leukaemia or some other situations which have had to do with the infection of the bone marrow. It is for this reason that zostavax a live attenuated varicella-zoster vaccine can impact and lead to disseminated disease in persons who are all immune bottled-up. With this said, do not administer zostavax to individuals on immunosuppressive therapy.


Women of child-bearing age and pregnant women are repudiated the consumption of zostavax.

Warnings and precautions

Transmission of vaccine virus

This occurs rarely between vaccines and susceptible contacts.

Primary varicella disease

Zostavax is not prescribed or recommended for the prevention of varicella infection that is chicken pox.

Preventing and managing allergic vaccine reactions

Just as it is with any other vaccine, sufficient treatment provisions with the inclusion of epinephrine injection should always be available for immediate use should in case and anaphylactic reaction occur.

Limitations of vaccine effectiveness

Proper protection beyond 4 years after vaccination with zostavax is unknown. Up to date, the need for taking on revaccination has not yet been defined. There is a possibility that vaccination with zostavax might not result in protection of all vaccine recipients.

Concurrent illness

Vaccination using this drug should be deferred in all patients with untreated active tuberculosis. It should also be deferred in cases of acute illnesses.

Adverse reactions

Clinical trials experience

Clinical trials are conducted under broadly varying conditions. All adverse event rates observed in clinical trials of a vaccine cannot be directly equated to rates in the clinical trials of another vaccine. They may not reflect the rates observed in practice.

Post-marketing experience

During post marketing uses of zostavax the following adverse reactions were identified. Due to the fact that these feedbacks are provided willingly from a population of an uncertain size, it is not probable to reliably evaluate their frequency.

  • Subcutaneous and skin disorders: rash
  • Connective tissue musculoskeletal disorders: myalgia
  • Hypersensitivity: This includes anaphylactic reactions.

Drug interactions

The concurrent administration of antiviral medication and zostavax known to be effective against VZV has not been evaluated.

Use in specific populations


Zostavax can cause foetus harm when administered to a pregnant woman. Nevertheless, natural occurring VZV infection is well known to cause harm to the foetus. One of the side effects of zostavax is that it reduces reproduction capacity. This is the reason why zostavax is not indicated for women of child-bearing age.

Nursing mothers

This drug is not indicated in women who are nursing. Up to present it is not known if VZV is secreted in human milk. But due to the fact that some viruses are secreted in human milk, lot of caution should be taken if zostavax is administered to a nursing mother.

Paediatric use

Zostavax uses are not for children or adolescents. It is not also indicated for the prevention of chickenpox.

Zostavax description

This drug is a lyophilized preparation of the Oka/Merck strain of live attenuated VZV. When this drug is properly reconstituted as directed, it is a sterile suspension for subcutaneous administration. Each of its 0.65 mL dose contains a minimum of 19,400 PFU. Each dose of this drug contains 31.16 mg of sucrose, 3.99 of sodium chloride, 15.58 mg of hydrolysed porcine gelatine, and 0.10 mg of potassium phosphate monobasic, 0.62 mg of monosodium and trace quantities of neomycin. This product contains no preservatives.

Zostavax –Clinical pharmacology

Operating mechanism

Decline in VZV –specific immunity relates to the risk of developing zoster. Zostavax was tested and found to boost VZV – specific immunity. This is the mechanism through which it protects against zoster together with other complications it comes with. Herpes zoster which is commonly known as zoster or shingles results from the manifestation of the reactivation of varicella zoster virus. Its primary infection is the production of chickenpox. Following primary infection, the virus remains dormant in the dorsal root until it reactivates. When it reactivates, it produces zoster. Zoster is generally characterised by a painful, unilateral and vesicular cutaneous eruption with a dermatomal distribution. During the prodrome, pain associated with zoster may occur. Pain which occurs during the postherpetic phase of infection is referred to as postherpetic neuralgia.

Patient counselling information


The health care provider is in charge of questioning the vaccine recipient about reaction to previous vaccines. The benefits and risks of taking zostavax as well its the different uses should be well explained to the vaccine recipient by the health care provider. All patients should be provided a copy of the patient information about zostavax uses. Patients should also be given the opportunity to discuss any questions they might have with the medical care provider. All patients who have taken the zostavax vaccine should be informed of the potential risk of transmitting the vaccine virus to any varicella-susceptible individual. This includes pregnant women who have not had chickenpox before. Patients be duty-bound to report any adverse reactions to their health care provider.

The FDA-Approved Patient Labelling

This summary of information should be read and all uses of zostavax understood before being vaccinated. Feel free to ask your health care provider any questions about zostavax. It should be noted that this information does not take the place of talking with your doctor. This is because only your health care provider can decide if zostavax is suitable for you or not.

How does it works?

Zostavax made up of a weakened chickenpox virus functions by fortifying your immune system against shingles. If it should happen that you still get shingles even after being vaccinated with zostavax, it will prevent the nerve pains that come with it. It should be noted that zostavax cannot be used to treat shingles when you already have it.

What to know about shingles and the virus that cause it

The same virus responsible for causing chicken pox is responsible for causing shingles. If you have once had chickenpox, it should be noted that the virus can stay in your system for many years. For a lot of reasons not understood by modern medicine, the virus can become active someday causing shingles. Problems with the immune system and increasing age can accelerate your chances of getting shingles. A rash that is usually on one side of the body is referred to as shingles. At the beginning, the rash appears as a cluster of small red spots that often blister. This rash is usually very painful. Shingles rashes are known to last for up to 30 days with its pains lessening as the rash heals. Zostavax is administered as a solitary dose by inoculation under the skin.

What are the ingredients of zostavax?

The main active ingredient in zostavax is a weakened form of the varicella-zoster virus. There exist several inactive ingredients in zostavax amongst which are; sodium chloride, hydrolysed porcine gelatine, sucrose, potassium phosphate monobasic, potassium chloride and sodium phosphate dibasic.

Zostavax overview

One of the main uses of zostavax is to prevent shingles in older people aged from 50 years and above. Even if you still get shingles after taking the zostavax vaccine, you will not be exposed to the nervous pains which follow shingles. It should be noted that zostavax does not protect everyone. For some people even after consumption of this vaccine still get attacked by shingles. Zostavax cannot be used to treat shingles or the nerve pains that follow it once you have it. But it can do a great job before. The zostavax drug is part of the drug class varicella zoster vaccines. Make sure you tell your doctor about all medicines you take, including non-prescription and prescription medicines. Always ask your doctor or pharmacist for more information.

Zostavax precautions


  • Concurrent illness, zostavax uses are not recommended for sick people.
  • It should be noted that vaccination with zostavax does not result in protection of all vaccine recipients.
  • Transmission of vairus might possibly occur between those who receive zostavax and susceptible contacts.
  • Children should never get zostavax for any reason.

Zostavax usage

  • For all uses of zostavax, it is carefully administered by a qualified health care provider.
  • For any zostavax use it is given as a single dose by injection under the skin, more precisely in the deltoid region of the upper arm.

Zostavax overdose

In all zostavax uses, only a health care provider in a medical setting determines the right amount of dose to be taken. When this is respected, it is unlikely that an overdose will occur along the process. Seek emergency medical attention if you suspect any signs of overdose.

Its form(s)

This medication may be available under multiple brand names or simply come in different forms. Not all the forms do operate as discussed above. This is why you need medical assistance in picking out that which works best for you. The zoster virus is now available under the new brand zoster II. If you are using this medication, make sure you speak with your doctor or pharmacist for the best information about your treatment options.

How to use this medication

This drug is one which is given just as a single injection under the skin of the outside of the upper arm. There are several things that can affect the dose of a drug that a person takes such as other medications, body weight and medical condition. Should in case your doctor has recommended a dose different from the one on the patient information sheet, do not change the way that you receive the medication without consulting the doctor again. It is very important that you take this medication just as it was prescribed to you by your doctor. Contact your doctor as soon as possible immediately after you miss an appointment to receive the vaccine. Always protect this medication from light. If possible store it in a refrigerator at temperatures between 2 and 8 degrees until it is mixed for injection. Its diluent should be stored at room temperature. Never dispose of medication in wastewater. Inquire from your doctor or pharmacist on how to dispose medication that has expired or that which is no longer needed.

Side effects of Zostavax

Many drugs come with side effects just like zostavax. This is an unwanted response to a medication when normal doses have been respected. If you are worried in about the risk and benefits of taking this drug, make sure you discuss them with your doctor before moving on. Not everyone who receives this medication experiences the following side effects. The side effects of zostavax have been reported at least by 1% of the people taking this drug. A lot of these side effects can be properly managed whereas others go a long way on their own. If you experience any of the severe side effects, make sure you contact your doctor. You pharmacist is better placed to advice you on how to manage zostavax side effects.

  • Fever
  • Diarrhea
  • Flu
  • Rash
  • Nausea
  • Runny nose
  • Weakness
  • Redness
  • Muscle or joint pain
  • Respiratory infections

You are recommended to call your doctor or reach emergency medical help if you have any of these allergic signs;

  • Difficulty in breathing;
  • Swelling of the lips;
  • Swelling of the tongue;
  • Hive;
  • Swelling of the throat.
  • Severe or painful skin rash;
  • Sore throat, swollen glands, flu symptoms and fever.

The following are less serious effects:

  • Diarrhea;
  • Headache;
  • Warmth, redness, pain, itching, or welling where the shot was made; and
  • Mild skin rash.

There is a possibility that some people experience side effects other than those listed above. They simply need to keep track of them and later inform their doctor. But if they are severe, a doctor should be called upon immediately. If you have an illness with fever, always talk to your doctor and ask him if you can take zostavax.


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