Varicella Vaccination of Immunocompromised Children

Levin, Myron J.

doi:10.1086/522133

Cited by 46 publications

(20 citation statements)

References 43 publications

(39 reference statements)

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“…In this study 9% (4/42) were found to not have a history of clinical infection or immunization against varicella placing them at risk, similar to the 10% found in the United States IBD survey[22]. The morbidity of varicella in immunosuppressed patients has led to studies challenging the general recommendation that this live attenuated vaccines not be administered[41]. A case series of six young people with IBD safely receiving varicella vaccination whilst on infliximab therapy[42].…”

Section: Discussionsupporting

confidence: 59%

An australian audit of vaccination status in children and adolescents with inflammatory bowel disease

et al. 2011

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BackgroundChildren and adolescents with inflammatory bowel disease (IBD) are at increased risk of vaccine preventable diseases (VPD). This includes invasive pneumococcal disease and influenza. The primary aim of this study was to describe compliance with current Australian guidelines for vaccination of children and adolescents diagnosed with IBD. A secondary aim was to review the serological screening for VPD.MethodsA random sample of patients (0-18 years at diagnosis), were selected from the Victoria Australia state based Pediatric Inflammatory Bowel Disease Register. A multi-faceted retrospective review of immunization status was undertaken, with hospital records audited, a telephone interview survey conducted with consenting parents and the vaccination history was checked against the primary care physician and Australian Childhood Immunization Register (ACIR) records. The routine primary childhood vaccinations and administration of the recommended additional influenza and pneumococcal vaccines was clarified.ResultsThis 2007 audit reviewed the immunization status of 101individuals on the Victorian Pediatric IBD database. Median age at diagnosis was 12.1 years, 50% were on active immunosuppressive therapy. 90% (38/42) [95% confidence intervals (CI) 77%; 97%] with complete immunization information were up-to-date with routine primary immunizations. Only 5% (5/101) [95% CI 2%; 11%] received a recommended pneumococcal vaccine booster and 10% (10/101) [95% CI 5%; 17%] had evidence of having ever received a seasonal influenza vaccine. Those living in rural Victoria (p = 0.005) and younger at the age of diagnosis (p = 0.002) were more likely to have ever received an influenza vaccine Serological testing, reviewing historical protection from VPD, identified 18% (17/94) with evidence of at least one serology sample.ConclusionThis study highlights poor compliance in IBD patients for additional recommended vaccines. A multi-faceted approach is required to maximize protection from VPD in this vulnerable special risk population.

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Section: Discussionsupporting

confidence: 59%

An australian audit of vaccination status in children and adolescents with inflammatory bowel disease

et al. 2011

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“…[16,29] Limiting vaccination to immune-compromised patients is not feasible, since the current vaccine contains live-attenuated VZV, which may replicate unchecked and disseminate in severely immunecompromised children. [30,31] Vaccination of close contacts of immune-compromised children, such as varicella-susceptible siblings, could be a practical strategy. The benefi t of administering the live varicella vaccine to potential contacts of immune-compromised patients far outweighs any theoretical risks of transmission.…”

Section: Discussionmentioning

confidence: 99%

Incidence and consequences of varicella in children treated for cancer in Guatemala

Brown

Asturias

Melgar³

et al. 2016

World J Pediatr

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“…Seroconversion rate and the effectiveness of more than 98% was observed in immunocompetent vaccine recipients after 2 doses of varicella vaccine [9]. Data from other immunocompromised populations including those with leukemia, chronic renal failure or chronic hepatic disease show seroconversion rate in a range of 85-100% [10].…”

Section: Discussionmentioning

confidence: 98%