Zostavax (zoster vaccine live)

Generic name: zoster vaccine live (ZOS ter vak SEEN LYV)
Brand name: Zostavax
Drug class: Viral vaccines

Zostavax vaccine was discontinued in the United States in November 2020. The information on this page is for historical reference only.

Zostavax (zoster vaccine live) is used to prevent herpes zoster virus (shingles) in people age 50 and older.

Herpes zoster is caused by the same virus (varicella) that causes chickenpox in children. When this virus becomes active again in an adult, it can cause herpes zoster, or shingles. Zoster vaccine is a live vaccine that helps prevent shingles.

Zostavax works by exposing you to a small dose of live virus, which causes the body to develop immunity to the disease. This vaccine will not treat an active infection that has already developed in the body.

Zostavax is used to prevent herpes zoster virus (shingles) in people age 50 and older.

Zostavax will not treat shingles or nerve pain caused by shingles (post-herpetic neuralgia).

Warnings

You should not receive Zostavax if you are pregnant or if you have active untreated tuberculosis, a weak immune system, leukemia or cancer that affects bone marrow, or if you have a history of allergic reaction to gelatin or neomycin.

You can still receive a vaccine if you have a minor cold. If you have tuberculosis, or any other severe illness with a fever or any type of infection, wait until you get better before receiving Zostavax.

Do not receive this vaccine if you have leukemia or lymphoma (or other cancer affecting bone marrow), a history of allergic reaction to neomycin (Mycifradin, Neo-Fradin, Neo-Tab). You should not receive Zostavax if you are pregnant, or if you have active untreated tuberculosis, any type of cancer that affects bone marrow, or a weak immune system caused by disease (such as HIV or AIDS) or by receiving medications such as steroids or chemotherapy.

Becoming infected with herpes zoster (shingles) is much more dangerous to your health than receiving this vaccine. However, like any medicine, Zostavax can cause side effects, but the risk of serious side effects is extremely low.

Before receiving this vaccine

You should not receive Zostavax if you have:

  • active untreated tuberculosis;
  • leukemia, lymphoma, or other cancer affecting bone marrow;
  • a history of allergic reaction to gelatin or neomycin (Mycifradin, Neo-Fradin, Neo-Tab);
  • a weak immune system caused by disease (such as HIV or AIDS), or by receiving medications such as steroids or chemotherapy; or
  • if you are pregnant.

To make sure Zostavax is safe for you, tell your doctor if you have:

  • a history of allergic reaction to any vaccine;
  • if you have received a "live" vaccine within the past 4 weeks; or
  • if you have never had chickenpox.

You can still receive a vaccine if you have a minor cold. If you have tuberculosis or any other severe illness with a fever or any type of infection, wait until you get better before receiving this vaccine.

Tell your doctor if someone in your household has a weak immune system. For a short time after you receive a Zostavax, it is possible that the live virus could be passed from you to any person who has a weak immune system.

It is not known whether Zostavax is harmful to an unborn baby. However, this vaccine is not for use in pregnant women. Avoid getting pregnant for at least 3 months after you have received a Zostavax.

It is not known whether zoster vaccine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Zostavax is not approved for use by anyone younger than 18 years old.

How is Zostavax given?

Zostavax is given as an injection (shot) under the skin. You will receive this vaccine in a doctor's office or other clinic setting.

Zostavax is usually given as a one-time injection. Unless your doctor tells you otherwise, you will not need a booster vaccine.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Dosing information

Usual Adult Dose for Herpes Zoster -- Prophylaxis:

0.65 mL subcutaneously in the deltoid once

Comments: Do not give IV or intramuscularly.

Use: Prevention of herpes zoster (shingles) in individuals 50 years of age and older.

What happens if I miss a dose?

Since Zostavax is given as a one-time injection, you are not likely to be on a dosing schedule.

What happens if I overdose?

An overdose of this vaccine is unlikely to occur.

What should I avoid before or after receiving Zostavax?

If you develop a skin rash that looks like shingles after receiving this vaccine, avoid coming into contact with other people who have never had chickenpox (especially newborns, pregnant women, or someone with a weak immune system). Also avoid contact with these individuals if you develop a rash or other reaction where the vaccine was injected into your skin.

Do not receive any other "live" vaccine for at least 4 weeks after your Zostavax, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), Bacillus Calmette-Guérin (BCG), oral polio, rotavirus, smallpox, typhoid, yellow fever, varicella (chickenpox), H1N1 influenza, and nasal flu (influenza) vaccine.

Zostavax side effects

You should not receive a second Zostavax if you had a life-threatening allergic reaction after the first shot.

Keep track of any and all side effects you have after receiving this vaccine. If you ever need to receive a booster dose, you will need to tell the doctor if the previous shots caused any side effects.

Becoming infected with shingles is much more dangerous to your health than receiving the vaccine to protect against it. Like any medicine, this vaccine can cause side effects, but the risk of serious side effects is extremely low.

Get emergency medical help if you have signs of an allergic reaction to Zostavax: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • fever, swollen glands, sore throat, flu symptoms;
  • breathing problems; or
  • severe or painful skin rash.

Common Zostavax side effects include:

  • headache; or
  • pain, warmth, redness, bruising, itching, or swelling where the shot was given.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.

What other drugs will affect Zostavax?

Before receiving this vaccine, tell your doctor about all other vaccines you have recently received.

Other drugs may interact with Zostavax, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.