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Varicella Exposure in Immunocompromised — RACP Paediatrics MCQ

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ModerateInfectious DiseaseVaricella Exposure in ImmunocompromisedRACP Paediatrics

A 4-year-old child attending daycare is diagnosed with varicella. His 2-year-old immunocompromised sibling (on chemotherapy) was exposed 2 days ago. What is the most appropriate post-exposure prophylaxis for the immunocompromised sibling?

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Correct answer: D — Zoster immunoglobulin (ZIG) as soon as possible

Immunocompromised children who are seronegative or have no history of varicella/vaccination and are exposed to VZV should receive zoster immunoglobulin (ZIG) as soon as possible, ideally within 96 hours of exposure. Live varicella vaccine is contraindicated in immunocompromised patients. ZIG reduces severity but may not prevent infection.

Reference: Australian Immunisation Handbook – 2025 – Varicella-Zoster