What should be done if a child or teen inadvertently receives live zoster vaccine (Zostavax, Merck) rather than Varicella Vaccine?
This is a serious vaccine administration error and procedures should be put in place to prevent this error from happening again. However, the dose of live zoster vaccine can be counted as one dose of varicella vaccine. If the error occurred for the first dose the person should receive the second dose of varicella vaccine on schedule.
I have a patient who is 62 years old and is immigrating to the U.S. She received a dose of live zoster vaccine 2 months ago. The immigration requirements state she should receive 2 doses of varicella vaccine. Does she need additional varicella vaccine?
To meet the immigration requirements, the dose of live zoster vaccine counts as the first dose of the varicella vaccine series. You should give a dose of varicella vaccine now since it has been more than 4 weeks since the dose of live zoster vaccine. The varicella vaccine dose may not be needed, but it will not be harmful and will allow your patient to meet the regulatory requirement. Note that if the vaccine she received was recombinant zoster vaccine (Shingrix, GlaxoSmithKline) it does NOT count as the first of two doses of varicella vaccine.
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