Post exposure prophylaxis for chickenpox and shingles
Post exposure prophylaxis (PEP) is offered to individuals at high risk of severe chickenpox following an exposure.
Applies to England
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Post exposure prophylaxis (PEP) is offered to individuals at high risk of severe chickenpox following an exposure. This includes immunosuppressed individuals, young babies in their first week of life and pregnant women.
After reviews of the effectiveness of antivirals and varicella zoster immunoglobulin (VZIG) in prevention of chickenpox, antiviral medication is now the post exposure treatment of choice for all immunosuppressed patients and pregnant women, regardless of stage in pregnancy. The only group of individuals where VZIG is recommended for PEP is those neonates exposed within one week of delivery, either in utero from maternal infection or post-delivery.
VZIG will only be issued for susceptible neonates exposed within one week of birth (either in utero from maternal infection, or post-delivery) or if oral antivirals are contraindicated due to malabsorption, or renal toxicity, or because the patient is less than 4 weeks of age.
See the detailed guide above, ‘Guidelines on post exposure prophylaxis (PEP) for varicella and shingles (January 2023)’, for the latest information.
All requests for stock and advice about issuing VZIG should be directed to the UK Health Security Agency (UKHSA) Rabies and Immunoglobulin Service (RIgS).
Last updated 24 January 2024 + show all updates
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Updated form.
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Updated 'Varicella zoster immunoglobulin clinical record form'.
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Updated guidance, see page 3 for changes.
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First published.