Vaccine-derived varicella zoster infection in a kidney transplant recipient after zoster vaccine live administration

Vaccine. 2019 Jun 12;37(27):3576-3579. doi: 10.1016/j.vaccine.2019.05.017. Epub 2019 May 17.

Abstract

A 49-year-old kidney transplant recipient, presented with a skin rash, and interstitial infiltrates three weeks after receiving a live attenuated varicella-zoster vaccine. Varicella-zoster Oka-vaccine strain was detected in plasma by polymerase chain reaction and sequencing analysis targeting open reading frame 62 (ORF 62). She was treated successfully with intravenous acyclovir. Our case report supports the current contraindication of live attenuated varicella-zoster vaccine in the solid-organ transplant recipients. Recombinant subunit varicella-zoster vaccine may be the vaccine of choice in these patients; nevertheless, further information is required to establish its safety, efficacy, and optimal timing.

Keywords: Herpes zoster; Kidney transplantation; Shingles; Shingrix; Solid organ transplantation; Zostavax; Zoster vaccine.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / administration & dosage
  • Antiviral Agents / administration & dosage
  • Chickenpox / diagnosis*
  • Chickenpox / drug therapy
  • Chickenpox / etiology*
  • Chickenpox / pathology
  • Chickenpox Vaccine / administration & dosage
  • Chickenpox Vaccine / adverse effects*
  • Female
  • Herpesvirus 3, Human / classification
  • Herpesvirus 3, Human / genetics
  • Herpesvirus 3, Human / isolation & purification*
  • Humans
  • Kidney Transplantation*
  • Middle Aged
  • Plasma / virology
  • Polymerase Chain Reaction
  • Sequence Analysis, DNA
  • Transplant Recipients*
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Chickenpox Vaccine
  • Acyclovir