Because pregnant women might be at higher risk for severe varicella and complications, use of varicella-zoster immune globulin (VZIG) should be strongly considered for pregnant women without evidence of immunity who have been exposed. However, administration of VZIG to pregnant women has not been found to prevent viremia, and therefore does not prevent fetal infection, congenital varicella syndrome, or neonatal varicella. The primary indication for VZIG in pregnant women is to prevent complications in the mother rather than to protect the fetus. To reduce the risk of severe disease in infants, ACIP recommends that neonates born to mothers who have signs and symptoms of varicella from 5 days before to 2 days after delivery should receive VZIG, regardless of whether the mother received VZIG. For premature neonates exposed to varicella postnatally, the following is recommended: • Those born at or after 28 weeks of gestation whose mothers do not have evidence of immunity should receive VZI