Varicella Zoster Virus Vaccination
Varicella zoster virus is highly infectious. It is very common in childhood, but is a mild illness.
Over 90% of the adults are immune and 80% of persons with no history of varicella infection are found to be seropositive.
• Primary varicella zoster virus infection in adults however can be severe, leading to pneumonia, myocarditis, pericarditis, encephalitis, and adrenal insufficiency.
• Pregnant women are more susceptible to severe illness from primary infection, with pulmonary complications occurring in about 10%.
• Severe illness may precipitate premature labor.
• Fetal infection may occur with a risk of 2 – 9% if maternal infection occurs before 20 weeks geatation. This may result in the congenital varicella syndrome, comprising of skin scarring, limb hypoplasia, microcephaly, cataract, neural damage, and growth retardation.
• Primary maternal infection within 4 days of delivery (before or after) carries a 30% risk of disseminated zoster infection in the newborn as transplacental transmission of IgG antibodies would not have been established.
Maternal infection following exposure in pregnancy can be confirmed by the presence of IgM antibodies or a four fold rise in IgG antibody titres.
The pregnant woman should be observed for signs of severe illness.
• Varicella zoster immune globulin (VZIG) may be given to exposed non-immune high risk pregnant woman to prevent or reduce the clinical manifestations. VZIG is expensive and therefore used only when strongly indicated.
• Anti-viral agents, e.g. acyclovir, should also be considered, either alone or along with VZIG.
• Neither VZIG nor antiviral drugs remove the risk of congenital malformations in the fetus.
Read more on immunization in pregnancy for the following conditions-
Vaccination during Pragnancy
Hepatitis B Vaccination during Pregnancy
Travel Vaccination during Pragnancy
Find more information on pre-pregnancy planning, infertility, healthy pregnancy, obstetric care, labor and delivery, postpartum wellness, and related topics.
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