Adults who are seronegative to varicella-zoster virus are recommended to receive either varicella or zoster vaccine
More than 97% of older people in Australia are seropositive to varicella-zoster virus (VZV) from previous natural infection,15 even if they cannot recall having varicella at a younger age.
Adults who are VZV-seronegative on laboratory testing and have no history of age-appropriate varicella vaccination may receive either:
- 2 doses of varicella vaccine (this is preferable — see Varicella), or
- 1 dose of zoster vaccine (if aged ≥50 years)
In some small studies, high-dose VZV-containing vaccine (comparable to Zostavax) was given to healthy VZV-seronegative adults and previously infected adults. The limited data suggest that the vaccine was well tolerated and immunogenic in seronegative people, but the incidence of self-limited injection site reactions may be slightly higher than in seropositive people.16,17 There are no specific studies of Zostavax safety in VZV-seronegative adults who have mild to moderate immunocompromising conditions. A cautious assessment of risk factors in these adults, both underlying disease and medication(s), is required.
Printed content may be out of date. For up to date information, always refer to the digital version: https://immunisationhandbook.health.gov.au/recommendations/adults-who-are-seronegative-to-varicella-zoster-virus-are-recommended-to-receive.