Public Health England (PHE) chickenpox post-exposure prophylaxis (PEP) guidelines were updated in August 2018. Varicella Zoster Immunoglobulin (VZIg) was replaced with oral aciclovir or valaciclovir in specific settings.


We retrospectively examined issues of VZIg between August 1 2017 and July 31 2018 at a transplantation centre that also had a large maternity service. In addition, since September 2018, information has been collected prospectively. Additional data were collected on exposure incident, patient risk group and any clinical or serological follow up.


Thirty issues of VZIg were identified retrospectively over 12 months. These included 9 pregnant women and 21 immunosuppressed patients, average age was 7.6 years (median 4.4 years, SD 11.1). Prospective outcome data were collected since September 4 2018 involving 2 pregnant women and 6 immunosuppressed individuals. Clinical follow-up information was available for 2 pregnant women and 16 immunosuppressed patients. One pregnant woman exposed to her own child with chickenpox and 2 immunosuppressed patients developed clinical varicella at an average of 15.3 days post VZIg. Five immunosuppressed patients were VZV IgG negative post-exposure. Follow-up available to date for 2 of 8 exposure incidents after the change in guidance has shown no clinical or serological evidence of varicella infection.


Where follow up information was available, 19 % developed attenuated VZV around 2 weeks after receiving VZIg. Given the new guidance on using aciclovir prophylaxis, prospective outcome data are being collected and no VZV infections have been noted to date.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article metrics loading...

Loading full text...

Full text loading...


Most cited this month Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error