Post Exposure Prophylaxis (PEP) with Varicella Immune Globulin

About varicella immune globulin

Varicella immune globulin (VariZIG, Cangene Corporation, Winnipeg, Canada) was FDA-approved in 2013, and is recommended for post exposure prophylaxis (PEP) by the Advisory Committee on Immunization Practices (ACIP) for certain individuals who can't receive the vaccine. For maximum effect, it should be given as soon as possible, but can be given for up to 10 days post-exposure.

Candidates for VariZIG:

• Are at high risk for severe varicella,
• Have had an exposure likely to result in infection, and
• Lack evidence of immunity to varicella.

Evidence of immunity to varicella includes:

• Documented varicella vaccination.
• Laboratory test for VZV IgG showing immunity, or laboratory confirmation of disease.
• Documented history from a health care provider of diagnosis of varicella (chickenpox) or zoster (shingles), or verification of a history of varicella or zoster.

Groups of exposed individuals recommended to receive VariZIG:

• Immunocompromised persons without evidence of immunity.
• Newborns whose mothers have signs and symptoms of varicella within 5 days before delivery or within 2 days after delivery.
• Premature infants born before 28 weeks of gestation or who weigh 1,000 g or less and were exposed during the neonatal period, regardless of evidence of maternal immunity.
• Premature infants born after 28 weeks or more of gestation and who were exposed during the neonatal period, in the absence of maternal immunity.
• Pregnant women without evidence of immunity.