1. Are adolescent and adult women in India at risk of Varicella infection?
- lndia is an endemic country for Varicella infection. As per an lndian study;12-20% of adolescents and young adult women are seronegative to Varicella; hence are susceptible to infection56
2. What are compications of chickepox during pregnancy?54,57
- Chickenpox complications vary depending upon when pregnant women contract Varicella infection.
- Congenital Varicella Syndrome in the neonate may be observed if the woman is infected with varicella during the first 20 weeks of gestation. The characteristic symptoms consist of skin lesions, neurologic defects and eye disorders
- Maternal pneumonia complicates about 10-20% of cases of chickenpox in pregnancy resulting in a higher mortality/morbidity than in non-pregnant adults. The risk for pneumonia also increases with increasing gestational age
- PerinataliNeonatal Varicella may occur when infection develops from 5 days before to 2 days after delivery
3. What are the recommendations for Varicella screening & vaccination?
FOGSI GCPR on preconception care, 2016 recommendsss
- Women should be screened for Varicella immunity in the preconceptional period by taking a history of past infections or previous vaccinations or by serology. (Strength of recommendation: A; quality of evidence lll)
- All the non-immune women should be vaccinated and counseled to avoid pregnancy for a month. (Strength of recommendation: A; quality of evidence lll)
- Vaccination against Varicella is recommended by the Global Bodies like ACOG, RCOG58,60
4. How long should pregnancy be avoided after Varicella vaccination?
- As per FOGSI GCPR Guidelines pregnancy should be avoided for one month following Varicella vacci nation55
What if a woman conceive within one month of Varicella vaccination or is already pregnant?
- Pregnant woman should not be vaccinated. As per CDC, if a pregnant woman is inadvertently vaccinated or becomes pregnant within 4 weeks after Varicella vaccination, she should be counseled about the theoretical basis of concern for the foetus; however, Varicella vaccination during pregnancy should not be considered a reason to terminate pregnancysa
5. What is Varilrix? How Varilrix is administered?
- Varilrix is GSK Varicella vaccine. Varilrix is intended for subcutaneous injection in the deltoid region of the arm or in the anterolateral part of the thigh. Please refer to product insert of vaccine for detailed information
6. What is the schedule of Varilrix for adolescents and adults?
- For adolescents 13 years of age or over and adults; Two doses of Varilrix are necessary. An interval of at least six weeks should be observed between the two doses, but in no case less than four weeks59
7. Varilrix safety information59
- As with other vaccines, the administration of Varilrix should be postponed in subjects suffering from acute severe febrile illness. ln healthy subjects, the presence of a minor infection, however, is not a contra-indication for immunisation
- Adverse effects reported are listed according to following frequency:
- Very common (1/10): redness, injection site pain.
- Common (1/100 to <1110): Eruptions,Swelling at the injection site, fever (oral/axi I lary temperature 237.5’C ;
rectal temperature 238.0’C).
- Uncommon (1/1,000 to <1/100): upper respiratory tract infection, pharyngitis, lymphadenopathy, irritability, headaches, drowsiness, cough, rhinitis, nausea, vomiting, papulo-vesicular eruptions, pruritus, myalgia, arthralgia, fever (oral/axillary temperature >39.0’C; rectal temperature >39.5″C), fatigue, malaise.