The first commercial varicella zoster immune globulin preparation available in the United States, VZIG, was prepared from plasma obtained from healthy, volunteer blood donors identified by routine screening to have high antibody titers to varicella-zoster virus, and became available in 1978. The definitions for susceptible children varied across studies and included children with negative or unknown history of varicella or those who were seronegative for varicella-zoster antibodies. ZIG also lowered attack rates and modified disease severity among susceptible immunocompromised children when administered within 72 hours after household exposure ( 5,6). Studies conducted in the late 1960s indicated that clinical varicella was prevented in susceptible, healthy children by administration of zoster immune globulin (ZIG) (prepared from patients recovering from herpes zoster) within 72 hours of household exposure ( 4). This report summarizes data on the timing of administration of varicella zoster immune globulin in relation to exposure to varicella-zoster virus and provides the CDC updated recommendations for use of VariZIG that replace the 2007 ACIP recommendations. The CDC recommendations for VariZIG use are now harmonized with the American Academy of Pediatrics (AAP) recommendations ( 3). CDC also has revised the patient groups recommended by the Advisory Committee on Immunization Practices (ACIP) to receive VariZIG by extending the period of eligibility for previously recommended premature infants from exposures to varicella-zoster virus during the neonatal period to exposures that occur during the entire period for which they require hospital care for their prematurity. CDC recommends administration of VariZIG as soon as possible after exposure to the varicella-zoster virus and within 10 days. VariZIG is now approved for administration as soon as possible following varicella-zoster virus exposure, ideally within 96 hours (4 days) for greatest effectiveness ( 2). Previously available under an investigational new drug (IND) expanded access protocol, VariZIG, a purified immune globulin preparation made from human plasma containing high levels of anti–varicella-zoster virus antibodies (immunoglobulin G), is the only varicella zoster immune globulin preparation currently available in the United States. In December 2012, the Food and Drug Administration (FDA) approved VariZIG, a varicella zoster immune globulin preparation (Cangene Corporation, Winnipeg, Canada) for use in the United States for postexposure prophylaxis of varicella for persons at high risk for severe disease who lack evidence of immunity to varicella* and for whom varicella vaccine is contraindicated ( 1). Updated Recommendations for Use of VariZIG - United States, 2013 For assistance, please send e-mail to: Type 508 Accommodation and the title of the report in the subject line of e-mail. Persons using assistive technology might not be able to fully access information in this file.
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