Update 2024:
A minor update was undertaken in 2024 to incorporate the recommendations of the UK Health Security Agency guidelines on post exposure prophylaxis (PEP) for varicella or shingles (January 2023).
Summary
Varicella, the primary infection with varicella-zoster virus (VZV; human herpesvirus 3), in pregnancy may cause maternal mortality or serious morbidity. It may also cause fetal varicella syndrome (FVS) and varicella infection of the newborn, which includes congenital varicella syndrome (CVS) and neonatal varicella.
This guideline addresses the role of varicella vaccination in susceptible women of reproductive age. The guideline also assesses the evidence regarding the maternal and fetal risks of VZV infection in pregnancy and whether or not these complications can be prevented or modified beneficially by the administration of varicella-zoster immunoglobulin (VZIG) or by treatment of infected individuals with aciclovir.
This information should guide the prudent use of VZIG, which is manufactured from the plasma of human blood donors and hence is a limited and expensive resource.
The management of neonates is outside the scope of this guideline. Guidance on neonatal exposure and disease is available on the www.gov.uk website.
Version history
Web copy update: The first edition of this guideline was published in 1997; the second edition was published in 2001; and the third edition was published in 2007. This is the fourth edition of this guideline, published in 2015; reviewed 2018 – no update required; reviewed 2021 – no update required; reviewed 2022 – no update required; 2024 – minor update to incorporate the UK Health Security Agency’s 2023 recommendations on post exposure prophylaxis (PEP) for varicella or shingles, ensuring alignment with emerging national public health guidance.
Developer declaration of interests
Available on request.