No abstract

Comment. The Centers for Disease Control and Prevention advise against administration of varicella vaccines to individuals with primary, acquired, or iatrogenic immunosuppression because the live attenuated vaccine strain can have devastating consequences in the immunocompromised host. Charkoudian and colleagues reported 2 cases of retinal necrosis following VZV vaccination. Both patients were significantly older (aged Ͼ70 years) than our case and consequently received Zostavax (which has 14 times more plaque-forming units than Varivax). Both vaccines, however, contain the Oka strain of live attenuated VZV. One of the patients described by Charkoudian and colleagues was iatrogenically immunosuppressed, as was our patient (in the case reported by Charkoudian and colleagues, it was for renal transplantation; in our case, it was for an inflammatory gastroenteropathy). The complication rate of retinitis following immunization with VZV vaccination is rare. To our knowledge, this is the first case that describes the same strain of VZV that is used in a vaccination campaign. While many microbiology laboratories can perform polymerase chain reaction to detect the presence of VZV DNA, identification of specific strains, including Oka, is not performed by most centers as more complex techniques are required.