If a provider chooses to administer Zostavax to a person who is immunocompromised or shortly expected to be immunocompromised, where there are no other contraindications after assessment with the Live zoster vaccine (Zostavax) screening for contraindications tool, serological testing should be performed before vaccination to confirm that the person is varicella-zoster virus (VZV) IgG-positive.
People who are immunocompromised or shortly expected to be immunocompromised and are seronegative for VZV IgG should not receive Zostavax. This is because they may have very severe outcomes after receiving Zostavax.38 See also Contraindications and precautions. If there is uncertainty, consult with the patient’s specialist or immunologist before administering Zostavax. A cautious approach, with detailed individual clinical assessment, is required before administering Zostavax.
See recommendations for adolescents and adults in the Varicella chapter for more information about vaccination for people who are seronegative for VZV IgG.
Serological testing is not required before administration of Shingrix in people who are immunocompromised or shortly expected to be immunocompromised.
