Administration of live attenuated varicella vaccine to children with cancer before starting chemotherapy

Varicella Vaccination of Immunocompromised Children

“…A reasonable conclusion is that these children will benefit from varicella vaccination if maintenance therapy is stopped for at least 1 week (in some cases for 11 week) before and after vaccination and if vaccination is undertaken during the maintenance phase of therapy. One study administered vaccine at the start of chemotherapy without any serious consequences and with immunological and clinical evidence of protection; however, only 500 pfu of virus was administered, and the chemotherapy was not described [31].…”

A review of the varicella vaccine in immunocompromised individuals

“…49 However, in another small study, the vaccine was administered to children with cancer on the first day of chemotherapy with promising results. 78 Seroconversion or an increase in the titers of VZV antibodies occurred in most of the vaccinees and only four of 13 seronegative children had mild adverse reactions to the vaccine (fever and/or rash). 78 This strategy may lead to early immunity protecting these high-risk children soon after the diagnosis of cancer and deserves further studies.…”

“…[66][67][68][69][70]73,77,78,83,84 In a Japanese study, a child with lymphosarcoma developed a varicella-like illness after vaccination. 61 Moreover, eight of 20 children with lymphoma who were given the vaccine developed rashes and in four of them the rash was severe.…”

“…36,[50][51][52][53][54][55][56][57][58][59][60][61] Many other small open-label trials have been conducted around the world. [62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78] In total more than 1200 children with ALL were given the live-attenuated varicella vaccine in open-label trials.…”

Supportive Care in Pediatric Oncology

“…Considering that 70 % of the mortality from VZV occurred in the fi rst year of treatment in the report by Caniza et al ( 2012 ) (a window where varicella vaccination is contraindicated), this is a recommendation that deserves further study. Cristófani et al ( 1991 ) administered live attenuated varicella vaccine to pediatric oncology patients on the fi rst day of chemotherapy. Twenty-two children without clinical history of varicella (retrospectively, 13 that were seronegative and 9 that were seropositive) were immunized.…”