American Board of Internal Medicine (ABIM) Certification Practice Exam

Which method has been found beneficial in preventing varicella infection in patients contraindicated to varicella vaccination when administered within a specific time frame?

1. Administration of passive immunoglobulin

2. Emergency vaccination with inactivated vaccine

3. Administration of the varicella vaccine

4. Preparation for antiviral therapy

The correct answer is: Administration of the varicella vaccine

The method identified as beneficial in preventing varicella infection in patients who are contraindicated for varicella vaccination is the administration of passive immunoglobulin. This approach is particularly effective as it provides immediate, but temporary, protection against the varicella virus. Passive immunoglobulin, often in the form of varicella zoster immunoglobulin (VZIG), contains antibodies against the varicella-zoster virus. It is administered to individuals who are at high risk of developing severe varicella infections but cannot receive the live attenuated varicella vaccine due to contraindications such as severe immunosuppression or allergy to vaccine components. The efficacy of passive immunoglobulin is particularly noted when it is given within 96 hours after exposure to the varicella virus, providing a crucial window for intervention that can significantly reduce the incidence and severity of the disease. While vaccination with the varicella vaccine is effective for those who can receive it, it is contraindicated for certain populations. Emergency vaccination with an inactivated vaccine does not apply here, as varicella is done with live attenuated virus; there is currently no inactivated varicella vaccine. Antiviral therapy serves as a treatment after infection rather than a preventative