varicella-zoster virus at a glance
Class
Viral vaccines: Varilrix is live attenuated; Shingrix is recombinant and adjuvanted.
Licensed roles
Varilrix prevents chickenpox; Shingrix prevents shingles and post-herpetic neuralgia.
What is varicella-zoster virus used for?
The products have different licensed purposes and are not interchangeable.
Shingrix: prevention of shingles and post-herpetic neuralgia in older adults and adults at increased risk of shingles.
Varilrix: active immunisation against chickenpox in eligible susceptible people, including defined high-risk circumstances.
Varilrix: post-exposure prevention in healthy, susceptible people when used promptly in accordance with official recommendations.
How does varicella-zoster virus work?
Varilrix produces an immune response to weakened Oka-strain virus. Shingrix presents viral glycoprotein E with the AS01B adjuvant, stimulating antibody and T-cell responses that help control reactivation of dormant virus.
How to take varicella-zoster virus
These vaccines are prepared and administered by a trained healthcare professional; food does not affect vaccination.
Shingrix is reconstituted and injected into a muscle, preferably in the upper arm.
Varilrix is reconstituted and injected under the skin or into a muscle in the arm or thigh; the under-skin route is used for people with bleeding disorders.
Tell the vaccinator about allergies, pregnancy, immune-system problems, bleeding disorders, current illness, recent blood products and other planned vaccines.
Vaccination is generally postponed during a severe feverish illness, although a minor infection such as a cold does not usually require delay.
varicella-zoster virus side effects
Common or expected effects
- Pain, redness or swelling at the injection site
- Fever or chills
- Headache, tiredness or feeling generally unwell
- Muscle aches
- Nausea, vomiting, diarrhoea or abdominal discomfort with Shingrix
- A local or more widespread chickenpox-like rash after Varilrix
Get urgent medical advice
- Anaphylaxis or another severe allergic reaction
- Encephalitis, seizures or loss of coordination reported rarely after live varicella vaccination
- Guillain-Barré syndrome reported very rarely after Shingrix
- Disseminated vaccine-strain infection, mainly reported in immunocompromised people receiving live varicella vaccine
varicella-zoster virus in pregnancy
Varilrix is contraindicated during pregnancy, and pregnancy should be avoided for one month afterwards. Shingrix is non-live, but routine use during pregnancy is avoided as a precaution because clinical data are limited. Guidance is reassuring after inadvertent exposure to either vaccine; contact a midwife, GP or specialist.
varicella-zoster virus while breastfeeding
Public-health guidance does not regard breastfeeding as a contraindication to varicella vaccination. The Varilrix SmPC recommends individual assessment because of a theoretical transmission risk; Shingrix is non-live, although direct breastfeeding data are limited.
varicella-zoster virus interactions
Provide a complete vaccination, medicine and blood-product history before vaccination.
Immunosuppressants, chemotherapy and high-dose corticosteroids
Varilrix may cause serious vaccine-strain infection in severe immunosuppression and is contraindicated in specified immunodeficiency states; Shingrix is non-live and may be used in eligible immunosuppressed adults.
Immunoglobulins or blood transfusions
Passively acquired antibodies may reduce the response to Varilrix, so timing requires clinical review.
Salicylates, including aspirin
The Varilrix SmPC advises avoiding salicylates after vaccination because Reye's syndrome has followed their use during natural chickenpox.
Common questions about varicella-zoster virus
Answers are fully visible for fast scanning and source review.
What are these vaccines used for?
Varilrix is used against chickenpox, while Shingrix prevents shingles and post-herpetic neuralgia.
Is Shingrix a live vaccine?
No. Shingrix contains a recombinant viral protein and an adjuvant, not live virus.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.