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Live Attenuated Varicella VaccineEfficacy for Children With Leukemia in Remission
Anne A. Gershon, MD;
Sharon Projansky Steinberg;
Lawrence Gelb, MD;
George Galasso, PhD;
William Borkowsky, MD;
Philip LaRussa, MD;
Angelo Ferrara, MD, PhD
JAMA. 1984;252(3):355-362.
Abstract
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One hundred ninety-one varicella-susceptible children with leukemia in remission were immunized with live attenuated varicella vaccine. There was serological evidence of an immune response in approximately 80% after one dose and in more than 90% after two doses. The major side effect was mild to moderate rash, seen especially in children with maintenance chemotherapy suspended for one week before and one week after vaccination. Children with rash had higher antibody titers than those without rash, but those with rash were also at risk (10%) to transmit vaccine virus to others. Twenty-two vaccinees subsequently had household exposures to varicella or zoster. The attack rate of clinical varicella in these vaccinees was 18%, significantly lower than the attack rate of approximately 90% in varicella-susceptible persons with household exposures. All cases of clinical illness were extremely mild, with an average of about 50 vesicles. The mild character of the illness was clearly different than varicella in unimmunized children receiving chemotherapy for leukemia. Varicella vaccine was approximately 80% effective in preventing clinical varicella in children with leukemia and completely effective in preventing severe varicella in this high-risk group.
(JAMA 1984;252:355-362)
Author Affiliations
The National Institute of Allergy and Infectious Diseases Varicella Vaccine Collaborative Study Group
From the Department of Pediatrics, New York University Medical Center, New York (Drs Gershon, Borkowsky, LaRussa, and Ferrara and Ms Steinberg); the National Institute of Allergy and Infectious Diseases, Bethesda, Md (Dr Galasso); and the Department of Medicine, Washington University, St Louis (Dr Gelb).
Footnotes
Reprint requests to Department of Pediatrics, New York University Medical Center, 550 First Ave, New York, NY 10016 (Dr Gershon).
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