Vaccinia Immune Globulin (VIG)

What is Vaccinia Immune Globulin, VIG

Vaccinia immune globulin VIG (VIG-IV) is an intravenous sterile solution of purified human immunoglobulin G (IgG) with trace amounts of IgA and IgM.

The product is derived from pooled adult human plasma collected from donors who received booster immunizations with the smallpox vaccine, vaccinia vaccine (Dryvax®).

All donors for the product are tested and found negative for antibodies against HIV, HBV, and HCV. Vaccinia immune globulin, VIG can be used to treat certain serious adverse reactions to smallpox vaccine such as progressive vaccinia, generalized vaccinia, eczema vaccinatum, or vaccinia infection in certain patients (see Dosage).

To date, there is no data from controlled trials regarding the impact of VIG-IV on mortality or smallpox complication severity. In 2003, based on international concerns regarding the use of smallpox as a biologic weapon, the CDC updated its recommendations for smallpox immunization to include the use of vaccinia immune globulin, VIG.

Additionally, to help healthcare facilities and state health officials prepare for such events, comprehensive disease information, a clinic guide, and a specific smallpox response plan are also available from the CDC.

Currently, in the U.S., vaccinia immune globulin, VIG can only be obtained by special request through the CDC Drug and Immunobiologics Service (404—639—3670) or the U.S. Military’s Department of Defense.

Two different formulations of VIG have been used clinically: an intravenous product (VIG-IV), manufactured by Dyn-Port and an intramuscular product (VIG-IM), manufactured by Baxter. While the type of VIG issued by the CDC will depend on availability, the VIG-IM product has recently been put into unlicensed status and will most likely not be available.

Intravenous Vaccinia Immune Globulin, VIG was in approved by the FDA in February 2005.

Indications

  • eczema vaccinatum
  • generalized vaccinia
  • vaccinia necrosum (progressive vaccinia)

For the treatment of vaccinia necrosum (progressive vaccinia); severe generalized vaccinia; eczema vaccinatum; vaccinia infection in patients who have skin conditions such as burns, impetigo, varicella-zoster, poison ivy, or eczematous skin lesions because of either the activity or extensiveness of such lesions; and for the treatment or modification of aberrant infections induced by vaccinia virus that include its accidental implantation in eyes (except in cases of isolated keratitis), mouth, or other areas where vaccinia infection would constitute a special hazard

Side Effects

  1. abdominal pain
  2. anaphylactic shock
  3. anaphylactoid reactions
  4. angioedema
  5. arthralgia
  6. aseptic meningitis
  7. azotemia
  8. back pain
  9. dizziness
  10. drowsiness
  11. dyspnea
  12. erythema
  13. fever
  14. flushing
  15. headache
  16. hemolysis
  17. hemolytic anemia
  18. hypotension
  19. hypoxia
  20. infection
  21. injection site reaction
  22. nausea
  23. ocular pain
  24. osmotic nephrosis
  25. photophobia
  26. pulmonary edema
  27. renal failure (unspecified)
  28. renal tubular necrosis
  29. urticaria
  30. vomiting

Monitoring Parameters

  • serum creatinine/BUN

Contraindications

  • arteriosclerosis
  • breast-feeding
  • children
  • coronary artery disease
  • diabetes mellitus
  • geriatric
  • heart failure
  • hypertriglyceridemia
  • hypovolemia
  • IgA deficiency
  • intramuscular administration
  • intravenous administration
  • keratitis
  • laboratory test interference
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment
  • sepsis
  • sucrose hypersensitivity
  • thimerosal hypersensitivity

Interactions

No information is available regarding drug interactions associated with Vaccinia Immune Globulin, VIG

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