A 30-year-old woman who is 16 weeks pregnant reports being in close contact with her nephew, who was just diagnosed with chickenpox. She is unsure if she has ever had chickenpox or received the vaccine. What steps should be taken?
Given her exposure and uncertain immunity, the woman is at risk for contracting chickenpox, which can be more severe in adults and can lead to complications in pregnancy. She should be evaluated for varicella immunity with serology. If she is not immune, she should receive VariZIG (varicella zoster immune globulin) as post-exposure prophylaxis within 10 days of exposure. The varicella vaccine is a live vaccine and should not be given during pregnancy.