Vaccination with live-attenuated or live vaccines is not recommended during ocrelizumab treatment and until B-cell repletion.ofatumumab SCSerious - Use Alternative (1)ofatumumab SC decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Administer all immunizations according to immunization guidelines at least 4 weeks prior to initiation of ofatumumab SC for live or live-attenuated vaccines, and whenever possible.onasemnogene abeparvovecContraindicated (1)onasemnogene abeparvovec decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Contraindicated. Adjust vaccinations to accommodate concomitant corticosteroid administration prior to and following onasemnogene abeparvovec infusion. Avoid live vaccines for at least 1 month when initiating or after high-dose systemic corticosteroid therapy administered for =2 weeks.oxaliplatinContraindicated (1)oxaliplatin decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.ozanimodSerious - Use Alternative (1)ozanimod decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid use of live-attenuated vaccines with ozanimod during treatment and for up to 3 months after discontinuing ozanimod. .ponesimodSerious - Use Alternative (1)ponesimod decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid use of live attenuated vaccines at least 1 month before initiating, during, and for 1-2 weeks after treatment. Coadministration with live attenuated vaccines may increase infection risk.prednisoloneSerious - Use Alternative (1)prednisolone decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.prednisoneSerious - Use Alternative (1)prednisone decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.procarbazineContraindicated (1)procarbazine decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo after cessation of immunosuppressive therapy.rabies immune globulin, human (RIG)Monitor Closely (1)rabies immune globulin, human (RIG) decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.Rho(D) immune globulinMinor (1)Rho(D) immune globulin decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Minor/Significance Unknown. Separate by 3 months.rilonaceptSerious - Use Alternative (1)rilonacept decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.risankizumabSerious - Use Alternative (1)risankizumab decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid use of live vaccines. Before starting risankizumab, complete age appropriate immunizations.ritlecitinibSerious - Use Alternative (1)ritlecitinib, varicella virus vaccine live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid live attenuated vaccines during or shortly before initiating ritlecitinib. No data are available on vaccination response in ritlecitinib treated patients. Before initiating, review patient immunization status (including herpes zoster) and immunize accordingly in agreement with current immunization guidelines.rituximabSerious - Use Alternative (1)rituximab, varicella virus vaccine live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Safety of immunization with live viral vaccines following rituximab therapy has not been studied and vaccination with live virus vaccines is not recommended.rituximab-hyaluronidaseSerious - Use Alternative (1)rituximab-hyaluronidase, varicella virus vaccine live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Safety of immunization with live viral vaccines following rituximab therapy has not been studied and vaccination with live virus vaccines is not recommended.salicylates (non-asa)Serious - Use Alternative (1)salicylates (non-asa), varicella virus vaccine live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.salsalateSerious - Use Alternative (1)salsalate, varicella virus vaccine live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.sarilumabSerious - Use Alternative (1)sarilumab, varicella virus vaccine live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid concurrent use of live virus vaccines, owing to potentially increased risk of infections. The interval between live vaccinations and initiation of sarilumab therapy should be in accordance with current vaccination guidelines regarding immunosuppressive agents.satralizumabSerious - Use Alternative (1)satralizumab decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. ive vaccines are not recommended during treatment. Administer all immunizations according to immunization guidelines. At least 4 weeks before initiating for live or live-attenuated vaccines.secukinumabContraindicated (1)secukinumab decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Contraindicated. Secukinumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating secukinumab, complete all age appropriate immunizations.siponimodSerious - Use Alternative (1)siponimod decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Pause vaccinations beginning 1 week before initiating siponimod and for 4 weeks after stopping treatment. Coadministration with live attenuated vaccines may increase infection risk.sirolimusSerious - Use Alternative (1)sirolimus decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.sulfasalazineSerious - Use Alternative (1)sulfasalazine, varicella virus vaccine live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.tacrolimusSerious - Use Alternative (1)tacrolimus decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.temsirolimusSerious - Use Alternative (1)temsirolimus decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.teplizumabSerious - Use Alternative (1)teplizumab decreases effects of varicella virus vaccine live by Other (see comment). Avoid or Use Alternate Drug. Comment: Administer all age-appropriate vaccinations before starting teplizumab. Live-attenuated vaccines are not recommended within 8 weeks before teplizumab treatment, during treatment, or up to 52 weeks after treatment.tetanus immune globulin (TIG)Monitor Closely (1)tetanus immune globulin (TIG) decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.tildrakizumabSerious - Use Alternative (1)tildrakizumab decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Before initiating tildrakizumab therapy, consider completion of all age appropriate immunizations according to current immunization guidelines. Avoid use of live vaccines in patients treated with tildrakizumab. No data are available on the response to live or inactive vaccines.tisagenlecleucelSerious - Use Alternative (1)tisagenlecleucel decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Vaccination with live virus vaccines is not recommended for at least 6 weeks before starting lymphodepleting chemotherapy, during CAR-T cell treatment, and until immune recovery following treatment. .tocilizumabSerious - Use Alternative (1)tocilizumab decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.tralokinumabSerious - Use Alternative (1)tralokinumab decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid use of live vaccines. Before starting tralokinumab, complete age appropriate immunizations.triamcinolone acetonide injectable suspensionSerious - Use Alternative (1)triamcinolone acetonide injectable suspension decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.ublituximabMonitor Closely (1)ublituximab decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.upadacitinibSerious - Use Alternative (1)upadacitinib decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.ustekinumabContraindicated (1)ustekinumab decreases effects of varicella virus vaccine live by Mechanism: pharmacodynamic antagonism. Contraindicated. Prior initiating therapy, patients should receive all age-appropriate immunizations as recommended by current guidelines. Immunosuppressants also increase risk of infection with concomitant live vaccines.Serious - Use Alternative (1)ustekinumab decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Contraindicated. Prior initiating therapy, patients should receive all age-appropriate immunizations as recommended by current guidelines. Immunosuppressants also increase risk of infection with concomitant live vaccines.vaccinia immune globulin intravenousMonitor Closely (1)vaccinia immune globulin intravenous decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Use Caution/Monitor. Defer live vaccines for 3 months after immune globulin administration.vedolizumabSerious - Use Alternative (1)vedolizumab decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid use of live virus vaccines while receiving vedolizumab; live vaccines may be administered concurrently with vedolizumab only if the benefits outweigh the risks.voclosporinSerious - Use Alternative (1)voclosporin decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.willow barkSerious - Use Alternative (1)willow bark, varicella virus vaccine live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination. Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System (VAERS), 1-800-822-7967 >10% Injection site swelling/rash/pruritus/erythema (20%) Fever >102°F [39°C] (15%) Postmarketing Reports Body as a whole: Anaphylaxis (including anaphylactic shock) and related phenomena such as angioneurotic edema, facial edema, and peripheral edema Eye disorders: Necrotizing retinitis (in immunocompromised individuals) Hemic and lymphatic system: Aplastic anemia; thrombocytopenia (including ITP) Infections and infestations: Varicella (vaccine strain) Nervous/psychiatric: Encephalitis; cerebrovascular accident; transverse myelitis; Guillain-Barré syndrome; Bell palsy; ataxia; nonfebrile seizures; aseptic meningitis; dizziness; paresthesia Respiratory: Pharyngitis; pneumonia/pneumonitis Skin: Stevens-Johnson syndrome; erythema multiforme; Henoch-SchÖnlein purpura; secondary bacterial infections of skin and soft tissue, including impetigo and cellulitis; herpes zoster Contraindications Hypersensitivity to gelatin, neomycin, or any component of the vaccine Pregnancy HIV: CD4+ count <200 cells/mcL Immunosuppressed or immunodeficient patients with lymphomas, leukemia, or malignant neoplasms affecting bone marrow or lymphatic system Patients receiving immunosuppressive therapy including immunosuppressive doses of corticosteroids Primary and acquired immunodeficiency states Current febrile illness (>101.3°F) Active untreated tuberculosis Cautions Avoid contact with high risk individuals up to 5 wk after vaccination Thermolabile: store at temperature -20°C or colder Syncope accompanied by transient visual disturbances, weakness, or tonic-clonic movements reported with injectable vaccines Postpone administration in patients with moderate or severe illness with or without fever; may administer to patients with mild illness with or without fever Avoid pregnancy for 3 months following therapy Defer vaccination in individuals with a family history of congenital or hereditary immunodeficiency until individual's immune status evaluated and found to be immunocompetent Advisory Committee on Immunization Practices (ACIP) has recommendations on use of varicella vaccine in HIV-infected individuals Immunoglobulins (IG) and other blood products should not be given concomitantly with this vaccine; the products may contain antibodies that interfere with vaccine virus replication and decrease expected immune response The ACIP has specific recommendations for intervals between administration of antibody-containing products and live virus vaccine Avoid use of salicylates (aspirin) or salicylate-containing products in children and adolescents 12 months through 17 years of age for six weeks following vaccination because of association of Reye syndrome with salicylate therapy and wild-type varicella infection Risk of vaccine virus transmission Post-marketing experience suggests that transmission of varicella vaccine virus (Oka/Merck) resulting in varicella infection including disseminated disease may occur between vaccine recipients (who develop or do not develop a varicella-like rash) and contacts susceptible to varicella including healthy as well ashigh-risk individuals Due to concern for transmission of vaccine virus, vaccine recipients should attempt to avoid whenever possible close association with susceptible high-risk individuals for up to six weeks following vaccination with this vaccine Susceptible high-risk individuals include Immunocompromised individuals, pregnant women without documented history of varicella or laboratory evidence of prior infection, newborn infants of mothers without documented history of varicella or laboratory evidence of prior infection and all newborn infants born at <28 weeks gestation regardless of maternal varicella immunity Pregnancy Category: X Lactation: Not known if excreted in