Vaccines for post-exposure prophylaxis against varicella (chickenpox) in children and adults

Abstract

BACKGROUND: Live attenuated varicella vaccines for the prevention of varicella (chickenpox) has been demonstrated both in randomised controlled trials (RCTs) and in population-based immunisation programmes in countries such as the United States. However, many countries do not routinely immunise children against varicella, and exposures continue to occur. Although the disease is often mild, complications such as secondary bacterial infection, pneumonitis and encephalitis occur in about 1% of cases, usually leading to hospitalisation. The use of varicella vaccine in persons who have recently been exposed to the varicella zoster virus has been studied as a form of post-exposure prophylaxis (PEP). OBJECTIVE: To assess the efficacy and safety of vaccines for use as PEP for the prevention of varicella in children and adults.

Vaccination of healthcare workers: A review

“…41,200,201 In addition, case reports of granulomatous dermatitis, 202 rash 203 and optic neuritis 204 have been published but the putative risk increase has not been confirmed by large scale comparative data. 41,200,201,205 At least 1 fatal systemic infection in an immunocompromised patient 206 has been observed. Less widespread types of VZV vaccines seem to have a good safety profile.…”

Postexposure management of healthcare personnel to infectious diseases

“…Varicella vaccine, not zoster vaccine, is effective in prevention of varicella infection (risk reduction of 60%-90%) and development of severe disease due to vaccine-induced VZV-specific T-cell proliferation if given within 3-5 days of exposure to an index case of varicella or zoster [34]. The disease is usually mild in vaccinated persons who did not seroconvert or who lost detectable antibody and developed varicella after exposure to VZV [4,35].…”

British HIV Association Guidelines on the Use of Vaccines in HIV‐Positive Adults 2015

“…Ongoing studies will determine whether effectiveness declines with time, and the requirement for boosters. The vaccines are also efficacious in preventing HPV-16 and HPV-18 infections at other anatomical sites in both sexes, including the precursors of vulvar, vaginal and anal cancer related to the vaccine types [2][3][4][40][41][42]. The 4vHPV and 9vHPV vaccines also reduce the incidence of genital warts associated with the vaccine types.…”

“…For women, studies differ in their conclusions about the age cut-off at which the cost-effectiveness ratio becomes unfavourable, ranging from 15 to 26 years within available data. The cost-effectiveness of vaccinating young males is generally lower than with young females, firstly because the burden of disease is lower in men than in women, and secondly because men derive benefits from female-only vaccination programmes via herd immunity, particularly if vaccine coverage is high [2][3][4]41,42,46]. Population-based studies in countries with high female vaccine coverage confirm a beneficial impact of herd immunity in heterosexual males; the benefit however is not extended to MSM.…”