Administering the Herpes Zoster Vaccine

Zoster vaccine is administered subcutaneously as a single dose in the deltoid region. The vaccine should not be injected intramuscularly. However, it is not necessary to repeat vaccination if it is administered intramuscularly.

The vaccine should be administered immediately after reconstitution to minimize loss of potency. Any unused vaccine should be discarded if not used within 30 minutes.

Administration with Other Vaccines

To avoid introducing barriers to patients who are interested in two important vaccines, CDC continues to recommend that zoster vaccine and pneumococcal vaccine be administered at the same visit if the person is eligible for both. When both pneumococcal conjugate vaccine PCV13 and PPSV23 are recommended for an adult, PCV13 should always be administered first and may be administered at the same time as the zoster vaccine.

Vaccine Administration Errors

Zoster vaccine should not be used in children and should not be used in place of varicella (chickenpox) vaccine. Also, varicella vaccine should not be used in place of zoster vaccine. Administration of zoster vaccine to a child who was supposed to be vaccinated with varicella vaccine is a serious vaccine administration error. The event should be documented and procedures put in place to prevent this from happening again. This event should be reported to the Vaccine Adverse Event Reporting System (VAERS) by phone 800-822-7967 or through the website. VAERS is maintained jointly by CDC and the Food and Drug Administration.

If a dose of zoster vaccine was given accidentally in place of varicella vaccine (Varivax®) for a child or an adult, then that dose of zoster vaccine should be counted the same as a single valid dose of varicella vaccine. That’s because the level of protection against varicella would probably be at least the same from zoster vaccine as for the conventional dose of varicella vaccine. If the erroneous dose was administered in lieu of the first dose of varicella vaccine, following such an error, a second dose of varicella vaccine is still required.

In the event that varicella vaccine was accidentally administered to an adult 60 years of age or older instead of zoster vaccine, Advisory Committee on Immunization Practices states: "If a provider mistakenly administers varicella vaccine to a person for whom zoster vaccine is indicated, no specific safety concerns exist, but the dose should not be considered valid and the patient should be administered a dose of zoster vaccine during that same visit. If the error is not immediately detected, a dose of zoster vaccine should be administered as soon as possible but not within 28 days of the varicella vaccine dose to prevent potential interference of 2 doses of live attenuated virus." The event should be documented and procedures put in place to prevent this from happening again.