Vaccinia Immune Globulin IV
Class: Antitoxins and Immune Globulins
Brands: CNJ-016
Introduction
Specific immune globulin (hyperimmune globulin). Vaccinia immune globulin IV (VIGIV) contains IgG prepared from plasma of adults immunized with smallpox (vaccinia) vaccine.
Uses for Vaccinia Immune Globulin IV
Smallpox Vaccination Complications
Treatment and/or management of certain complications of smallpox vaccination, including eczema vaccinatum, progressive vaccinia, severe generalized vaccinia, vaccinia infection in individuals with certain skin conditions (e.g., burns, impetigo, varicella zoster virus infection, poison ivy, active or extensive eczematous skin lesions), and aberrant vaccinia infection caused by inadvertent autoinoculation to the eyes (except isolated vaccinia keratitis), mouth, or other areas where such infection would constitute a special hazard. Designated an orphan drug by FDA for this use.
Considered first-line treatment for serious complications of smallpox vaccination. Contraindicated in patients with isolated vaccinia keratitis; not recommended for treatment of postvaccinial encephalitis.
If VIGIV alone is inadequate or if VIGIV not readily available, may consider use of certain antivirals (e.g., cidofovir, tecovirimat, brincidofovir) for treatment of complications of smallpox vaccination after consultation with CDC.
Contact state or local health department or CDC Emergency Operations Center at 770-488-7100 for assistance with diagnosis and management of suspected complications of smallpox vaccination.
Monkeypox
Although efficacy data not available, CDC states that there are certain circumstances when VIGIV may be considered for treatment of severe monkeypox†. In addition, CDC states that use of VIGIV may be considered for postexposure prophylaxis of monkeypox† in exposed individuals who cannot receive postexposure vaccination with smallpox vaccine because of severe T-cell function immunodeficiency.
Monkeypox virus is an orthopoxvirus closely related to the causative agent of smallpox. Although no specific treatments are available for monkeypox infection, CDC states that monkeypox outbreaks can be controlled through use of smallpox vaccine, VIGIV, and certain antivirals (e.g., cidofovir, tecovirimat, brincidofovir).
If an outbreak of monkeypox occurs in the US, CDC will establish updated guidelines for use of smallpox vaccine, VIGIV, or antivirals for treatment and/or postexposure prophylaxis of exposed individuals.
Vaccinia Immune Globulin IV Dosage and Administration
General
Ensure that patient is adequately hydrated and assess renal function (e.g., BUN and Scr) prior to administration of VIGIV and at appropriate intervals thereafter.
Closely monitor for adverse effects and evaluate vital signs during and immediately following IV infusion of VIGIV.
Administration
Administer only by IV infusion.
IV Infusion
Administer through a dedicated IV line. If preexisting catheter must be used, fl...
