Special Warning : אזהרת שימוש

4.4   Special warnings and precautions for use

Traceability
In order to improve the traceability of biological medicinal products, the name and the batch number of the administered product should be clearly recorded.

Appropriate medical treatment and supervision should always be readily available in case of a rare anaphylactic/anaphylactoid reaction following the administration of the vaccine, as there is a possibility of hypersensitivity reactions, not only to the active substances, but also to the excipients and trace residuals (e.g. neomycin) present in the vaccine (see sections 4.3, 4.8 and 6.1).

Neomycin allergy generally manifests as a contact dermatitis. However, a history of contact dermatitis due to neomycin is not a contraindication to receiving live virus vaccines.

ZOSTAVAX is a live, attenuated varicella-zoster vaccine and administration to individuals who are immunosuppressed or immunodeficient may result in disseminated varicella-zoster virus disease, including fatal outcomes. Patients who previously received immune suppressive therapy should be carefully evaluated for the reconstitution of the immune system prior to receiving Zostavax (see section 4.3).

The safety and efficacy of ZOSTAVAX have not been established in adults who are known to be infected with HIV with or without evidence of immunosuppression (see section 4.3) however, a phase II safety and immunogenicity study in HIV-infected adults with conserved immune function (CD 4+T cell count ≥ 200 cells/µL) has been completed (see sections 4.8 and 5.1).

ZOSTAVAX is not indicated for treatment of zoster or PHN.

Immunisation should be postponed in individuals suffering from moderate to severe acute febrile illness or infection.

As for any vaccine, vaccination with ZOSTAVAX may not result in protection in all vaccine recipients.
See section 5.1.

Transmission
In clinical trials with ZOSTAVAX, transmission of the vaccine virus has not been reported. However, post-marketing experience with varicella vaccines suggests that transmission of vaccine virus may occur rarely between vaccinees who develop a varicella-like rash and susceptible contacts [for example, varicella-zoster virus (VZV) -susceptible infant grandchildren]. Transmission of vaccine virus from varicella vaccine recipients who do not develop a varicella-like rash has also been reported. This is a theoretical risk for vaccination with ZOSTAVAX. The risk of transmitting the attenuated vaccine virus from a vaccinee to a susceptible contact should be weighed against the risk of developing natural zoster and potentially transmitting wild-type VZV to a susceptible contact.

Sodium
This medicinal product contains less than 1 mmol sodium (23 milligrams) per dose, that is to say essentially ‘sodium-free’.

Potassium
This medicinal product contains less than 1 mmol potassium (39 milligrams) per dose, that is to say essentially ‘potassium-free’.

Effects on Driving

4.7   Effects on ability to drive and use machines

No studies on the effects on the ability to drive or use machines have been performed. However, ZOSTAVAX is expected to have no or negligible influence on the ability to drive and use machines.