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

Kraft, John N.

doi:10.1001/archderm.142.7.943

Cited by 65 publications

(32 citation statements)

References 8 publications

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“…Varivax is not approved by the FDA for use in immunocompromised patients because of risk for disseminated varicella due to vaccine virus. Such dissemination occurred in an adult seronegative cardiac transplant recipient who was vaccinated 2 years posttransplant and required hospitalization and intravenous acyclovir (68). In contrast, two studies in pediatric liver recipients described minimal adverse events with immunization, predominantly a small number of vesicles at sites distant from the vaccination site (69,70).…”

Section: Vzv Preventionmentioning

confidence: 99%

“…Limited data in children with transplants suggests that vaccination with Oka strain attenuated vaccines is relatively safe (69,70,72) but similar data in adults are lacking. If seronegative patients are vaccinated following transplantation, they should be informed of the potential risks of dissemination (68) and early treatment with acyclovir be made available. Patients who are not vaccinated, or…”

Section: Vzv Seronegative Patientsmentioning

confidence: 99%

See 1 more Smart Citation

Herpes Simplex and Varicella Zoster Viruses: Forgotten but Not Gone

Miller

Dummer

2007

American Journal of Transplantation

102

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Herpesvirus infections are common complications of organ transplantation. The most frequent herpesvirus infections are caused by cytomegalovirus (CMV), herpes simplex (HSV) and varicella zoster (VZV). Despite expansion of the therapeutic armamentarium, HSV and VZV continue to cause morbidity and occasional mortality in transplant recipients. Here we review the incidence and risk factors for HSV and VZV disease, their clinical presentation, effects of newer immunosuppressive regimens and prophylaxis for HSV and VZV in solid organ transplant recipients.

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Section: Vzv Preventionmentioning

confidence: 99%

Section: Vzv Seronegative Patientsmentioning

confidence: 99%

Herpes Simplex and Varicella Zoster Viruses: Forgotten but Not Gone

Miller

Dummer

2007

American Journal of Transplantation

102

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“…Only one prior report has described the effects of varicella vaccine in an immunocompromised patient; a 36-year-old heart transplant recipient was given the vaccine and, like the patient described here, developed disseminated cutaneous herpes zoster, with polymerase chain reaction (PCR) studies of swab cultures confirming vaccine strain of VZV. 4 In June 2007, the Centers for Disease Control and Prevention Advisory Committee of Immunization Practices issued an update on the safety of Zostavax®. 5 Through June 1, 2007, 590 reports had been submitted to the Vaccine Adverse Events Reporting System.…”

Section: Discussionmentioning

confidence: 99%

Live, Attenuated Varicella Zoster Vaccination of an Immunocompromised Patient

2008

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A vaccine for the prevention of herpes zoster outbreaks in adults over the age of 60 years has recently been approved. A 76-year-old white female with a history of recurrent left axillary breast cancer undergoing chemotherapy was given a Zostavax® injection by her primary care physician. Eight days later, the patient developed a rash. Given the recent administration of live, attenuated varicella zoster virus (VZV), a diagnosis of disseminated cutaneous herpes zoster was made. The patient was treated successfully with a course of famciclovir for 10 days and cephalexin for 7 days for a secondary bacterial infection. A review of the medical literature disclosed no reports of Zostavax® given to adult cancer patients immunocompromised by systemic chemotherapy. Therefore, we believe this report is the first to describe the consequences of Zostavax® administration to such a host. Clinicians should take care to review contraindications and precautions prior to administering the Zostavax® vaccine.

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“…For example, inadvertent administration of varicella vaccine to a seronegative heart transplant recipient has been reported to cause disseminated varicella [45]. Therefore, live vaccines are generally suggested to be given at least 4 weeks prior to transplant.…”

Section: Live-attenuated Vaccines (Varicella and Measles-mumps-rubella)mentioning

confidence: 99%