Varicella vaccination in children with nephrotic syndrome: a report of the Southwest Pediatric Nephrology Study Group.
OBJECTIVE
To evaluate the safety and immunogenicity of varicella vaccine in children with nephrotic syndrome, including those taking low-dose, alternate-day prednisone.


METHODS
Prospective, open-label, multicenter clinical trial of varicella vaccine in a 2-dose regimen in US and Canadian children (12 months to <18 years) with nephrotic syndrome. Varicella Zoster Virus (VZV) antibody levels were measured after the first and second vaccine dose and yearly for 2 years. Patients were monitored for adverse reactions to vaccine, exposure to varicella, dermatomal zoster, and chickenpox.


RESULTS
Twenty-nine children, mean age 4.9 (SD 1.9) years, 45% receiving every-other-day steroids, received 2 vaccine doses. All patients seroconverted and had VZV antibody levels considered protective against breakthrough varicella (>or=5 gpELISA units) after 2 doses. At 2-year follow-up, all patients retained detectable antibody, and 91% (21 of 23) had levels >or=5 gpELISA units. There were no adverse events associated with vaccination.


CONCLUSIONS
Varicella vaccine was generally well tolerated and highly immunogenic in children with nephrotic syndrome, including those on low-dose, alternate-day prednisone.
Furth
Susan L
SL
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Arbus
Gerald S
GS
Hogg
Ronald
R
Tarver
Joyce
J
Chan
Christina
C
Fivush
Barbara A
BA
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000914:Antibodies, Viral / Q000097:blood; D000917:Antibody Formation / Q000276:immunology; D002170:Canada; D019433:Chickenpox Vaccine / Q000009:adverse effects / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D014645:Herpesvirus 3, Human / Q000276:immunology; D006801:Humans; D007115:Immunization Schedule; D008297:Male; D009404:Nephrotic Syndrome / Q000097:blood / Q000188:drug therapy / Q000276:immunology*; D011241:Prednisone / Q000627:therapeutic use; D011446:Prospective Studies; D012449:Safety; D014481:United States
D000893:Anti-Inflammatory Agents; D000914:Antibodies, Viral; D019433:Chickenpox Vaccine; D011241:Prednisone