Varicella Vaccination of Immunocompromised Children

Levin, Myron J.
March 2008
Journal of Infectious Diseases;Mar2008 Supplement 2, Vol. 197, pS200
Academic Journal
Background. Exposure of immunocompromised children to varicella often requires postexposure prophylaxis. Exposures requiring this management are often not recognized. Varicella can he a severe disease when it occurs in immunocompromised children, in spite of antiviral therapy. Varicella exposure and varicella in these children can also disrupt scheduled therapy for their underlying illness. Both postexposure prophylaxis and treatment of varicella are likely to be expensive and use significant medical resources. Numerous trials have been undertaken to vaccinate children who are immunocompromised by a variety of conditions and therapies that depress their immune function. Methods. Clinical trials of varicella vaccine administration to immunocompromised children that were reported since 1975 were identified in the Ovid medical database. Reports were selected for analysis and discussion on the basis of their completeness and the utility of their conclusions. Results. Vaccination before immune compromise is discussed as a strategy for some settings. The obstacles, potential opportunities, and success in varicella vaccination for immunocompromised children are separately analyzed for (1) children with leukemia and other malignancies, (2) human immunodeficiency virus-infected children, and (3) children with hematopoietic stem cell or solid-organ transplantation. Conclusions. Vaccination before immune compromise is often successful, and the vaccine-induced response is usually partially or fully protective. In many treatment settings, it is possible to safely vaccinate once the level of immune suppression has been reduced. Targets for future research are outlined. A consensus conference should be undertaken to develop guidelines for the use of varicella vaccine in immunocompromised children.


Related Articles

  • Development of Varicella Vaccine. Takahashi, Michiaki; Asano, Yoshizo; Kamiya, Hitoshi; Baba, Koichi; Ozaki, Takao; Otsuka, Terumasa; Yamanishi, Koichi // Journal of Infectious Diseases;Mar2008 Supplement 2, Vol. 197, pS41 

    The Oka strain of varicella-zoster virus (VZV) was first isolated from vesicles of an otherwise healthy 3-year- old boy with typical varicella. The virus was passaged 11 times in human embryonic lung fibroblasts at 34°C and 12 times in guinea pig embryo fibroblasts (GPEFs) at 37°C. GPEFs...

  • Perspective on Live Varicella Vaccine. Gershon, Anne A.; Katz, Samuel L. // Journal of Infectious Diseases;Mar2008 Supplement 2, Vol. 197, pS242 

    The attenuation of varicella-zoster virus (VZV) by Takahashi in 1974 was a remarkable achievement. It swiftly led to development of a live vaccine against chickenpox, which was initially tested in Japan. With its successful employment in immunocompromised children to prevent morbidity and...

  • Risk of Herpes Zoster in Adults Immunized with Varicella Vaccine. Hambleton, Sophie; Steinberg, Sharon P.; Larussa, Philip S.; Shapiro, Eugene D.; Gershon, Anne A. // Journal of Infectious Diseases;Mar2008 Supplement 2, Vol. 197, pS196 

    A program of routine varicella vaccination of children 12-18 months of age, begun in the United States in 1995, has been very successful in reducing the incidence of varicella. Varicella-zoster virus (VZV), in both wild-type and live attenuated forms, is notable for its ability to produce latent...

  • Varicella Vaccine Effectiveness in the US Vaccination Program: A Review. Seward, Jane F.; Mann, Mona; Vázquez, Marietta // Journal of Infectious Diseases;Mar2008 Supplement 2, Vol. 197, pS82 

    Varicella vaccine (Varivax, Merck) has been available in the United States since 1995. We reviewed published results of postlicensure studies of vaccine effectiveness. Among 19 studies, 17 reported on the effectiveness of vaccine received before exposure, and 2 reported on effectiveness after...

  • Vaccine Oh Variants and Sequence Variability in Vaccine-Related Skin Lesions. Breuer, Judith; Scott Schmid, D. // Journal of Infectious Diseases;Mar2008 Supplement 2, Vol. 197, pS54 

    As with most live attenuated viral vaccines, varicella vaccine comprises a mixture of variant strains. Knowledge about the pathogenic potential of individual strains in the varicella vaccine is limited. Vaccination against chickenpox causes a usually modified varicella-like rash in a small...

  • The Impact of Varicella Vaccination on Herpes Zoster in Children. Jenson, Hal B. // Infectious Disease Alert;Sep2009, Vol. 28 Issue 12, p133 

    A POPULATION-BASED TELEPHONE SURVEY WAS CONDUCTED among residents < 20 years of age in Antelope Valley, CA, from 2000 through 2006. During this period, 459 evaluable cases of herpes zoster among persons < 20 years of age were reported. Of these cases, 154 (34%) were among children < 10 years of...

  • Humoral and Cell-Mediated Immune Responses in Children and Adults after 1 and 2 Doses of Varicella Vaccine. Watson, Barbara // Journal of Infectious Diseases;Mar2008 Supplement 2, Vol. 197, pS143 

    Humoral and cell-mediated immune responses to varicella-zoster virus (VZV) have been evaluated after 1 and 2 doses of live attenuated varicella vaccine, Oka strain, in several studies. One dose of varicella vaccine, however, elicits detectable immune responses that are low and, in some cases,...

  • An Economic Analysis of the Universal Varicella Vaccination Program in the United States. Fangjun Zhou; Ortega-Sanchez, Ismael R.; Guris, Dalya; Shefer, Abigail; Lieu, Tracy; Seward, Jane F. // Journal of Infectious Diseases;Mar2008 Supplement 2, Vol. 197, pS156 

    Frequent varicella outbreaks with sizable impact on the US public health system have continued to occur despite the success of the country's 1-dose varicella vaccination program. The Advisory Committee on Immunization Practices recently recommended adding a routine second dose of varicella...

  • Varicella Immunogenicity with 1- and 2-Dose Regimens of Measles-Mumps-Rubella-Varicella Vaccine. Shinefield, Henry R.; Black, Steve; Kuter, Barbara J. // Journal of Infectious Diseases;Mar2008 Supplement 2, Vol. 197, pS152 

    A quadrivalent vaccine combining measles, mumps, rubella, and varicella antigens (MMRV) was developed to increase the coverage of varicella vaccine and reduce the number of injections children receive. Although the varicella antigen is as immunogenic in the latest formulation of MMRV vaccine as...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics