Zostavax vaccine

Safety advisory – not to be used in patients with compromised immune function

7 March 2017

The TGA has received a report of a death occurring in a person with pre-existing compromised immune function after receiving Zostavax – a live, attenuated varicella-zoster virus vaccine that is used to prevent shingles and prevention/treatment of nerve pain associated with the virus.

Zostavax should not be used in people who are immunocompromised, as this is associated with a risk of mild to serious complications (including death) from infection with the vaccine virus.

Zostavax is used for:

  • prevention of herpes zoster (shingles) in people aged 50 years and older
  • prevention of post-herpetic neuralgia (nerve pain due to damage caused by the varicella-zoster virus) and for reduction of acute and chronic zoster-associated pain in individuals 60 years of age and older.

Zostavax was included in the National Immunisation Program on 1 November 2016 for the prevention of herpes zoster in patients 70 years of age. A five-year catch-up program for people aged 71-79 years is also underway.

Further information about the use of Zostavax among immunocompromised patients has recently been distributed to general practitioners and general practice nurses via state/territory health departments.

Information for consumers

If you are concerned about whether you or someone you provide care for can receive Zostavax, please speak to your health professional.

Patients with medical conditions or taking medicines that affect the immune system may not be suitable for Zostavax.

It is important that you discuss your medical history with your doctor before vaccination.

Further information about contraindications can be found in the Zostavax Consumer Medicine Information.

Information for health professionals

Health professionals are reminded that Zostavax is contraindicated in patients with compromised immune function.

Zostavax contains live attenuated varicella-zoster virus, containing 14 times more virus than childhood varicella vaccines.

Administration of Zostavax can result in disseminated disease from the vaccine virus in individuals who are immunosuppressed or immunodeficient.

Health professionals should carefully consider a patient’s immunological status prior to vaccination and not administer Zostavax in immunodeficient or immunosuppressed patients. If unsure, defer vaccination and seek specialist advice.

Further information about contraindications can be found in the Zostavax Product Information.

The Australian Immunisation Handbook also contains information about Zostavax administration in special populations, including patients who are immunocompromised or have medical conditions that place them at risk of immunocompromise. Additionally, information can also be obtained from the National Centre for Immunisation Research and Surveillance.

Reporting problems

Consumers and health professionals are encouraged to report problems with medicines or vaccines. Your report will contribute to the TGA’s monitoring of these products.

The TGA cannot give advice about an individual's medical condition. You are strongly encouraged to talk with a health professional if you are concerned about a possible adverse event associated with a medicine or vaccine.