Children born to mothers who had chicken pox (not zoster) within five days before delivery or within 48 hours after delivery should be treated with prophylactic varicella immunoglobulin or IVIG if varicella immunoglobulin is not available within 10 days.
A useful mnemonic is V(five days before)aricell(two days after)a
Other indications for varicella immunoglobulin include people without evidence of immunity who are exposed to chicken pox including:
- Immunocompromised children
- Pregnant women
- Hospitalized premature infant (>28 weeks) whose mother lacks immunity
- Hospitalized premature infant < 28 weeks gestation or birth weight less than 1000g regardless of maternal immunity.
Healthy children greater than one year of age who have not yet been vaccinated should be given the varicella vaccine within five days of exposure.
American Academy of Pediatrics. Varicella-Zoster Virus Infections. In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2018 Report of the Committee on Infectious Diseases. American Academy of Pediatrics; 2018;