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.
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Printed content may be out of date.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.