Varicella Infection Caused by Oka Strain Vaccine in a Heart Transplant Recipient

Live viral vaccines in transplanted patients

“…There was no efficacy or safety issue reported: seroconversion rates varied between 65% and 100% (table 3), and side effects were similar to the healthy population. When a follow-up of antibody titres was reported, they waned moderately, and breakthrough disease was rarely reported [36][37][38]. In our institution, VZV-specific CMI also increased significantly after immunisation, in a cohort of 36 paediatric liver transplant recipients [34].…”

Live Virus Vaccines in Transplantation: Friend or Foe?

“…As expected, chickenpox occurs significantly less frequently and with less complications in seropositive SOT recipients, compared with those who never received the vaccine or without a history of chickenpox [15,43,44]. Despite isolated case reports suggesting that varicella vaccine is not always safe in transplant recipients [45,46], several studies have shown that it may be safe and efficient in selected SOT recipients, with close monitoring during and after immunization [7,18,21,32,47]. Between 1994 and 2012, seven prospective interventional studies of VZV vaccine in SOT pediatric recipients have been published.…”

Efficacy and safety of measles, mumps, rubella and varicella live viral vaccines in transplant recipients receiving immunosuppressive drugs

“…Six studies [1][2][3][4][5][6] and two case reports [7,8] met the inclusion criteria. They reported use of 179 doses of measles vaccine, measles, mumps, and rubella vaccine (MMR), and/or varicella vaccine in 112 children and 2 adults who had received solid organ transplants 1.5 to 201 months previously and were on a wide variety of immunosuppressive regimes (Table 1).…”

“…Waning of titers occurred in all studies that included follow-up serology. [1][2][3] Ten of the 89 patients who received varicella vaccine developed possible vaccine-associated localized or generalized rash [2,3,[5][6][7][8] although isolation of virus was attempted in only one case, yielding the vaccine strain. [8] The duration of clinical follow-up was not always reported, but 3 cases of mild varicella [2] and no cases of measles, mumps, or rubella occurred in vaccine recipients.…”