Healthy subjects: Varilrix is indicated for active immunisation against varicella of healthy subjects from the age of 12 months onwards.
High-risk patients and healthy close contacts: Varilrix is also indicated for active immunisation against varicella of susceptible high- risk patients and their susceptible healthy close contacts.
Patients with acute leukaemia: Patients suffering from leukaemia have been recognised to be at special risk when they develop varicella, and should receive vaccine if they have no history of the disease or are found to be seronegative.
When immunising patients in the acute phase of leukaemia maintenance chemotherapy should be withheld one week before and one week after immunisation. Patients under radiotherapy should normally not be immunised during the treatment phase.
Patients under immunosuppressive treatment: Patients under immunosuppressive treatment (including corticosteroid therapy) for malignant solid tumour or for serious chronic diseases (such as chronic renal failure, auto- immune diseases, collagen diseases, severe bronchial asthma) are predisposed to severe varicella.
Generally patients are immunised when they are in complete haematological remission from the disease. It is advised that the total lymphocyte count should be at least 1,200 per mm3 or no other evidence of lack of cellular immune competence exists.
Patients with planned organ transplantation: If organ transplantation (e.g. kidney transplant) is being considered, immunisation should be carried out a few weeks before the administration of the immunosuppressive treatment.
Patients with chronic diseases: Other chronic diseases, such as metabolic and endocrine disorders, chronic pulmonary and cardiovascular diseases, mucoviscidosis and neuromuscular abnormalities may also predispose to severe varicella.
Healthy close contacts: Susceptible healthy close contacts should be immunised in order to reduce the risk of transmission of virus to high-risk patients. These include parents and siblings of high-risk patients, and medical, paramedical personnel and other people who are in close contact with varicella patients or high-risk patients.