Safety and immunogenicity of one vs. two injections of Oka/Merck varicella vaccine in healthy children

Ngai, Angela; Staehle, Brenda; Kuter, Barbara J.; Cyanovich, Nancy; Cho, Iksung; Matthews, Holly; Keller, Paul M.; Arvin, Ann M.; Watson, Barbara; White, C. J.

doi:10.1097/00006454-199601000-00011

Cited by 63 publications

(31 citation statements)

References 10 publications

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“…Injection site pain was reported in <10% of subjects in each group after both doses. In contrast to previous studies [24,27,32], no increase in local reactions was observed from dose 1 to dose 2 in either group. Local symptoms of a high intensity were rare.…”

Section: Safety and Reactogenicitycontrasting

confidence: 99%

Safety, immunogenicity and immediate pain of intramuscular versus subcutaneous administration of a measles–mumps–rubella–varicella vaccine to children aged 11–21 months

et al. 2010

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This study compared intramuscular and subcutaneous administration of two doses of measles-mumps-rubella-varicella (MMRV) combination vaccine (Priorix-Tetra, GlaxoSmithKline Biologicals) in children. Healthy children (N = 328) were randomised to receive MMRV either intramuscularly or subcutaneously. Reactogenicity was similar between treatment groups for immediate vaccination pain, vaccination site pain, redness and incidence of fever and rashes. Slightly less vaccination site swelling occurred during days 0-3 of the post-vaccination period after intramuscular administration. Seroconversion rates for all components, 42-56 days post-dose 2, ranged from 99.3% to 100% in the intramuscular group and from 98.6% to 100% in the subcutaneous. Cell-mediated immunity data supported the humoral immunogenicity findings. In summary, the MMRV vaccine is well tolerated and highly immunogenic when administered either subcutaneously or intramuscularly to children in the second year of life.

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Section: Safety and Reactogenicitycontrasting

confidence: 99%

Safety, immunogenicity and immediate pain of intramuscular versus subcutaneous administration of a measles–mumps–rubella–varicella vaccine to children aged 11–21 months

et al. 2010

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“…In June 2006, the Advisory Committee on Immunization Practices recommended a routine 2-dose schedule for varicella vaccination, to improve vaccine-induced immunity and the control of varicella and to minimize the burden of breakthrough varicella disease [24]. Clinical studies have suggested that a second dose of varicella vaccine could provide increased protection against varicella, thus reducing the risk of breakthrough disease by 3-fold [25][26][27]. As this new vaccine schedule is implemented, it will be important to continue to monitor changes in varicella epidemiology, with a focus on varicella disease among vaccinated persons and the agespecific rates of serious complications.…”

Section: Discussionmentioning

confidence: 99%

Varicella Disease among Vaccinated Persons: Clinical and Epidemiological Characteristics, 1997–2005

et al. 2008

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Approximately 1 in every 5 children who receives 1 dose of varicella vaccine may develop varicella disease, also known as breakthrough disease, if exposed to varicella-zoster virus. Currently, in communities with high vaccination coverage, varicella cases mostly occur in vaccinated individuals. We report on the first population-based description of the clinical and epidemiological characteristics of varicella in populations with increasing vaccine coverage between 1997 and 2005. In vaccinated children 1-14 years of age, varicella was most often mild and modified; the atypical disease presentation may result in diagnostic challenges to health care providers. However, despite the generally mild nature of these cases, approximately 25% caused >50 lesions, and some resulted in serious complications similar to those occurring in unvaccinated individuals. Continued surveillance of the risk and characteristics of breakthrough disease will be needed, to monitor the effect of the new 2-dose vaccine recommendation for children.

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“…The vaccine virus propagates in varicella-naïve persons at the injection site, as evidenced by occasional local skin lesions containing vaccine virus. Vaccination must also occasionally cause a viremia, as indicated by the appearance of VZV in skin lesions distant from the injection site in a minor proportion of vaccinees (Ngai et al 1996). Vaccine strain VZV also gains access to peripheral ganglia, either by ascending the peripheral nerve that innervates the injection site or as a consequence of viremia, as evidenced by the subsequent late appearance of HZ caused by Oka strain VZV (Galea et al 2008;Levin et al 2008a).…”

Section: Varicella Vaccinementioning

confidence: 99%

VZV T Cell-Mediated Immunity

Weinberg

Levin

2010

Current Topics in Microbiology and Immunology

148

138

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Primary varicella-zoster virus (VZV) infection (varicella) induces VZV-specific antibody and VZV-specific T cell-mediated immunity. T cell-mediated immunity, which is detected within 1-2 weeks after appearance of rash, and consists of both CD4 and CD8 effector and memory T cells, is essential for recovery from varicella. Administration of a varicella vaccine also generates VZV-specific humoral and cellular immune responses. The memory cell responses that develop during varicella or after vaccination contribute to protection following re-exposure to VZV. These responses are subsequently boosted either by endogenous re-exposure (silent reactivation of latent virus) or exogenous re-exposure (environmental). VZV-specific T cell-mediated immunity is also necessary to maintain latent VZV in a subclinical state in sensory ganglia. When these responses decline, as occurs with aging or iatrogenic immune suppression, reactivation of VZV leads to herpes zoster. Similarly, the magnitude of these responses early after the onset of herpes zoster correlates with the extent of zoster-associated pain. These essential immune responses are boosted by the VZV vaccine developed to prevent herpes zoster.

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Safety and immunogenicity of one vs. two injections of Oka/Merck varicella vaccine in healthy children

Cited by 63 publications

References 10 publications

Safety, immunogenicity and immediate pain of intramuscular versus subcutaneous administration of a measles–mumps–rubella–varicella vaccine to children aged 11–21 months

Safety, immunogenicity and immediate pain of intramuscular versus subcutaneous administration of a measles–mumps–rubella–varicella vaccine to children aged 11–21 months

Varicella Disease among Vaccinated Persons: Clinical and Epidemiological Characteristics, 1997–2005

VZV T Cell-Mediated Immunity

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