This document provides recommendations on the use of Zostavax® that will be available free to eligible people under the National Immunisation Program (NIP).
Zostavax® is free for all adults 70 years of age from November 2016.
A single catch-up dose will be funded for adults aged 71-79 years until 31 October 2021.
Zostavax® contains live attenuated varicella-zoster virus.
A single dose (0.65ml) vaccine is given by subcutaneous injection in the deltoid region.
Zostavax® must be reconstituted with the diluent before administration and given immediately (discard if not used within 30 minutes).
Zostavax® can be given at the same time as the influenza vaccine or pneumococcal polysaccharide vaccine, using separate syringes and injection sites.
Zostavax® can be administered at the same visit as, or at any time before or after receipt of, inactivated vaccines (e.g. tetanus-containing vaccines).
Take care to ensure that the appropriate route of injection is used for all vaccinations.
Note: recommendations for co-administration have been taken from the online version of The Australian Immunisation Handbook 10th edition and may differ from the product information.
Zostavax® is safe for most older people, including those with common chronic diseases (arthritis, hypertension, chronic renal failure, diabetes, COPD and other similar conditions).
Zostavax® is contraindicated in persons with significant immunocompromise due to either a primary or acquired medical condition, or due to medical treatment.
Anaphylaxis to any component of the vaccine.
Note: Detailed information on contraindications and precautions is provided in the online version of The Australian Immunisation Handbook 10th edition Chapter 4.
Zostavax® is recommended, but not funded, for people 60 years and over as this age group is at an increased risk of shingles and its complications.
People who are not eligible to receive the free vaccine are able to purchase the vaccine on the private market.
Note: Routine vaccination of persons aged 70–79 years is expected to obtain the greatest benefits against shingles and its complications. Further information is provided in the online version of The Australian Immunisation Handbook 10th edition.
Zostavax® is not registered for the treatment of shingles or shingles related post-herpetic neuralgia (PHN). Individuals presenting with an acute illness should defer immunisation until they are fully recovered. A person who has had an episode of shingles is recommended to wait at least a year between recovering from the infection and having the vaccine.
A previous history of chickenpox infection is not a pre-requisite for receiving Zostavax®. The vast majority of adults aged over 60 years in Australia have had primary infection with the varicella zoster virus (VZV) and are therefore at risk of reactivation of latent VZV, causing shingles. Although an individual over 60 years may not remember having had chickenpox, they can still receive the shingles vaccine.
The Shingles Prevention Study assessed efficacy in >38,000 subjects aged 60 years and older and found that Zostavax® reduced the risk of shingles by 51.3 per cent and the risk of post-herpetic neuralgia (PHN) by 66.6 per cent.
Shingles can still occur in people who have received the vaccine, but it is likely to be milder and less likely to result in PHN.
One dose of the vaccine is thought to be protective for approximately 5-10 years, and possibly longer. Studies to monitor the duration of protection of the vaccine are being undertaken.
The Shingles Prevention Study and other smaller similar studies demonstrate that Zostavax® is safe and generally well tolerated. The most common mild side effects include: redness, soreness, swelling, or itching at the site of the injection, headache and fatigue.
Adverse events following immunisation
Adverse events following immunisation should be reported through the usual reporting mechanisms in your state or territory.
Reporting to the Australian Immunisation Register
The Australian Childhood Immunisation Register has now become the Australian Immunisation Register (AIR) and from September 2016, will accept data on vaccines administered to people of all ages. Providers are required to submit data to the AIR on all Zostavax® doses administered.
The need for a booster dose has not yet been determined, however should surveillance data indicate one is needed in the future, vaccine recipients will be able to be recalled using data captured in the AIR.
Immunisation providers will be able to order supplies of Zostavax® using the usual NIP vaccine ordering channels. Your state or territory health department will inform you when you can commence ordering Zostavax®. You can begin administering the vaccine as soon as you receive your supplies.
Contacts and further information
State and territory health department contact details:
ACT - 02 6205 2300
SA - 1300 232 272
NSW - 1300 066 055
TAS - 1800 671 738
NT - 08 8922 8044
VIC - 1300 882 008
QLD - 13 HEALTH (13 43 25 84)
WA - 08 9388 4999
Information brochures for patients and waiting room posters have been produced to support the introduction of this vaccine.
You can order or print copies of these products through the Immunise Australia website.