Safety of Live Attenuated High-Titer Varicella-Zoster Virus Vaccine in Pediatric Allogeneic Hematopoietic Stem Cell Transplantation Recipients

Biol Blood Marrow Transplant. 2016 Apr;22(4):771-775. doi: 10.1016/j.bbmt.2015.12.025. Epub 2015 Dec 31.

Abstract

Hematopoietic stem cell transplantation (HSCT) recipients have a high risk of varicella-zoster virus (VZV) infections. Although VZV vaccination may be beneficial in preventing VZV infections, data on safety and efficacy of VZV vaccines in HSCT recipients, particularly of zoster vaccine, are limited. We report our experience with the use of a single dose of an Oka strain high-titer zoster-equivalent varicella vaccine in pediatric allogeneic HSCT recipients. We administered the high-titer VZV vaccine to 31 pediatric allogeneic HSCT recipients without vaccine-type VZV infections. One patient developed varicella due to wild-type VZV 13 days after vaccination. No zoster developed after vaccination during a median follow-up period of 4.8 years from vaccination. No other adverse effects were observed. Eighteen of the 31 patients (58.1%) were seropositive after vaccination. Seventeen patients were vaccinated within 24 months after HSCT; the seropositivity of these patients did not significantly differ from that of patients vaccinated > 24 months after HSCT. VZV vaccination may be a safe and beneficial approach in preventing VZV infections after HSCT.

Keywords: Allogeneic hematopoietic stem cell transplantation; Pediatrics; Varicella-zoster virus vaccine.

MeSH terms

  • Adolescent
  • Chickenpox Vaccine / administration & dosage*
  • Child
  • Child, Preschool
  • Female
  • Hematologic Neoplasms / immunology
  • Hematologic Neoplasms / pathology
  • Hematologic Neoplasms / therapy*
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Hematopoietic Stem Cell Transplantation / methods
  • Herpes Zoster / immunology
  • Herpes Zoster / prevention & control*
  • Herpes Zoster / virology
  • Herpesvirus 3, Human / drug effects
  • Herpesvirus 3, Human / immunology
  • Humans
  • Infant
  • Male
  • Myeloablative Agonists / therapeutic use*
  • Patient Safety
  • Retrospective Studies
  • Transplantation, Homologous
  • Vaccination*
  • Vaccines, Attenuated
  • Virus Activation / drug effects

Substances

  • Chickenpox Vaccine
  • Myeloablative Agonists
  • Vaccines, Attenuated