Safety and immunogenicity of varicella-zoster virus vaccine in pediatric liver and intestine transplant recipients.
Primary varicella-zoster virus (VZV) infections following organ transplantation may cause significant morbidity. We examined the safety and immunogenicity of Varivax after transplantation as a potential prophylactic tool. Pediatric liver and intestine transplant recipients without history of chickenpox received one dose of Varivax. VZV humoral and cellular immunity were assessed before and > or =12 weeks after vaccination. Adverse events (AE) and management of exposure to wild type VZV were monitored. Sixteen VZV-naïve subjects, 13-76 months of age, at 257-2045 days after transplantation were immunized. Five children developed mild local AE of short duration. Four subjects developed fever and four developed non-injection site rashes, three of whom received acyclovir. Liver enzymes did not increase during the month after vaccination. Eighty-seven percent and 86% of children developed humoral and cellular immunity, respectively. There were five reported exposures to varicella in four children, none of which resulted in chickenpox. One subject received VZV-immunoglobulin and another subject with liver enzyme elevations after exposure received acyclovir; all remained asymptomatic. Varivax was safe and immunogenic in pediatric liver and intestine transplant recipients. Larger studies are needed to establish the efficacy and role of varicella vaccination after transplantation.
Dept. Pediatrics, University of Colorado Health Services Center, Denver, CO, USA.
A
A
Weinberg
S P
SP
Horslen
S S
SS
Kaufman
R
R
Jesser
A
A
Devoll-Zabrocki
B L
BL
Fleckten
S
S
Kochanowicz
K R
KR
Seipel
M J
MJ
Levin
D002644:Chickenpox / Q000517:prevention & control* / Q000635:transmission; D019433:Chickenpox Vaccine / Q000627:therapeutic use*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects*; D007223:Infant; D007422:Intestines / Q000637:transplantation*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D016896:Treatment Outcome
D019433:Chickenpox Vaccine