Immunogenicity and Reactogenicity of a Single Dose of Live Attenuated Varicella Vaccine and a Booster Dose of Measles–Mumps–Rubella Vaccine Given Concomitantly at 12 years of Age

Abstract

Universal varicella-zoster virus (VZV) childhood vaccination is still debated, but adult chickenpox may be severe. It could be prevented by vaccination of seronegative adolescents. This study aimed to determine the feasibility of coadministration of a VZV vaccine and the measles-mumps-rubella (MMR) booster at 12 y of age. Guardians of 1231 12-y-old pupils where asked about the history of chickenpox in their children. 190 had no chickenpox history and 12 of 62 of them lacked VZV antibodies. Additional history-negative children were also recruited. 199 history-positive children received only MMR and 98 history-negative children received an MMR vaccine and a VZV vaccine. Serum samples were drawn before vaccination and after 8 weeks. Viral antibodies were measured by immunofluorescence (VZV) and enzyme-linked immunosorbent assays (VZV, MMR). All 184 history-positive children tested had VZV antibodies. 17/89 VZV-vaccinated and tested children (19%) lacked VZV antibodies before vaccination. 12 (71%) seroconverted after 1 dose. Cell-mediated immunity (CMI) against varicella was tested in 3/5 children who did not seroconvert after 1 dose of VZV vaccine. They seroconverted after a second dose and had measurable CMI. VZV vaccination did not affect the MMR response and there were no severe side-effects. A history of varicella infection, as reported by the guardian, is reliable, but a negative history was incorrect in 81% of the cases. This population of 12-y-old children may require 2 doses of VZV vaccine, at least when given simultaneously with the MMR vaccine.

Changes in seroprevalence to four herpesviruses over 30 years in Swedish children aged 9–12 years

“…Varicella-zoster virus (VZV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV) infections become more severe if contracted after puberty. In a recent study in Sweden (Parment et al, 2003) the seroprevalence for VZV was approximately 97% in 12 years old children, which was higher than expected (Strom, 1982). An increase in the seroprevalence during the past decades may have occurred.…”

Varicella seroepidemiology in United States air force recruits: A retrospective cohort study comparing immunogenicity of varicella vaccination and natural infection

“…The true duration of immunity after vaccination has not been established, and published studies describing long-term seroprevalence of anti-VZV antibodies among vaccinated persons are limited by small sample sizes [9]. While several studies have characterized seroprevalence of anti-VZV antibodies among various populations, there are no large studies characterizing long-term seroprevalence in a cohort with documented vaccine receipt compared to a cohort with documented history of chickenpox.…”

“…As verified by serologic surveys, confirmation of disease through either medical record review or patient/-parent recall of disease has high sensitivity and positive predictive value in unvaccinated adolescents [8,9]. Seroconversion estimates following varicella vaccination are approximately 60-70% after one dose and 88% after two doses [9,10].…”

“…As verified by serologic surveys, confirmation of disease through either medical record review or patient/-parent recall of disease has high sensitivity and positive predictive value in unvaccinated adolescents [8,9]. Seroconversion estimates following varicella vaccination are approximately 60-70% after one dose and 88% after two doses [9,10]. Despite a randomized controlled trial demonstrating one-dose vaccine efficacy of 94% and two-dose efficacy of 98% after 10 years [11], varicella outbreaks in immunized children with attack rates of 10-13% suggest varicella vaccine effectiveness of 82-85% among one-dose recipients and 86-88% among two-dose recipients [12][13][14].…”

Parental reports of adverse events following simultaneously given dT-IPV and MMR vaccines in healthy 9-year-old children

“…About 95% of all children seroconvert after the first dose of MMR, which is given at 14 months of age. Of infants receiving this dose, 5-15% experience adverse events like fever and rash during the viremic period beginning at least 5 days after vaccination [11,23,29]. The risk of idiopathic thrombocytopenic purpura is also increased after the first MMR vaccination [4].…”