Varicella (var), “chickenpox shot"—give SC
  • All susceptible adults and adolescents should be vaccinated. Make special efforts to vaccinate susceptible persons who have close contact with persons at high risk for serious complications (e.g., health care workers and family contacts of immunocompromised persons) and susceptible persons who are at high risk of exposure (e.g., teachers of young children, day care employees, residents and staff in institutional settings such as colleges and correctional institutions, military personnel, adolescents and adults living with children, nonpregnant women of childbearing age. and international travelers who do not have evidence of immunity).

    Note: People with reliable histories of chickenpox (such as self or parental report of disease) can be assumed to be immune. For adults who have no re liable history, serological testing may be cost-effective because most adults with a negative or uncertain history of varicella are immune.
  • Two doses are neeeded
  • Dose #2 is given 4-8 wk after dose #1.
  • May be given with all other vaccines but at a separate site.
  • If varicella vaccine and MMR are both needed and arc not administered on the same day, space them at least 4 wk apart.
  • if the second dose is delayed, do not repeat dose #1. Just give dose #2.
  • Previous anaphylactic reaction to this vaccine or to any of its components.
  • Pregnancy, or possibility of pregnancy within 1 month.
  • Immunocompromised persons due to malignancies and primary or acquired cellular immunodeficiency, including HIV/AIDS.

    Note: For those on highdose immunosuppressive therapy, consult ACIP recommendations regarding delay time.
  • If blood products or immune globulin have been administered during the past 5 months, consult the ACIP recommendations regarding time to wait before vaccinating.
  • Moderate or severe acute illness.

    Note: Manufacturer recommends that salicylates be avoided for 6 weeks after receiving varicella vaccine because of a theoretical risk of Rcye syndrome.
Polio(IPV)—give IM or SC
  • Not routinely recommended for persons 18 years of age and older.

    Note: Adults living in the United States who never received or completed a primary series of polio vaccine need not be vaccinated unless they intend to travel to areas where exposure to wild-type virus is likely. Previously vaccinated adults should receive one booster dose if traveling to polio endemic areas.
  • Four doses of inactivated polio vaccine (IPV) at 2,4, and 6-18 mo, and 4-6 yr.
  • May be given with all other vaccines but at a separate site.
Lyme disease—give IM
  • Consider for persons 15-70 years of age who reside, work, or recreate in areas of high or moderate risk and who engage in activities that result in frequent or prolonged exposure to tick-infested habitat.
  • Persons with a history of previous uncomplicated Lyme disease who are at continued high risk for Lyme disease. (Sec description in the first bullet.)
  • See ACIP statement for a definition of high and moderate risk.
  • Three doses are needed. Give at intervals of 0, 1, and 12 mo. Schedule dose #1 (given in year 1) and dose #3 (given in year 2) to be given several weeks before tick season. See ACIP statement for details.
  • Safety of administering Lyme disease vaccine with other vaccines has not been established.
  • ACIP says if it must be administered concurrently with other vaccines, give it at a separate site.
  • Previous anaphylactic reaction to this vaccine or to any of its components.
  • Pregnancy.
  • Moderate or severe acute illness.
  • Persons with treatment-resistant Lyme arthritis.
  • There are not enough data to recommend Lyme disease vaccine to persons with these conditions: immunodeficiency, diseases associated with joint swelling (including rheumatoid arthritis) or diffuse muscular pain, chronic health conditions due to Lyme disease.