YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==CHICKENPOX VACCINE - VARICELLA== 8 AUTHOR Takahashi M TITLE Current status and prospects of live varicella vaccine. SOURCE Vaccine; VOL 10, ISS 14, 1992, P1007-14 (REF: 73) ABSTRACT Since its development in 1974 the Oka strain live attenuated varicella vaccine has been tested in healthy and immunocompromised adults and children. Its safety and efficacy have been established and it is now licensed for general use in Japan and Korea, and for immunocompromised patients in several other countries. Possibilities for the future include its use to prevent zoster in the elderly, its incorporation in a multivalent vaccine and its use as a vehicle to express foreign genes in recombinant vaccines. 2 AUTHOR Arbeter AM TITLE Clinical trials of varicella vaccine in healthy adolescents and adults. SOURCE Infect Dis Clin North Am; VOL 10, ISS 3, 1996, P609-15 (REF: 21) ABSTRACT Adolescents and adults have an increased risk of severe and, rarely, fatal varicella. Increased risk of exposure of susceptible teens and adults occurs because of the more common use of day care and nursery programs, and more common exposure of health care workers to herpes zoster. The exposure of susceptible parents to their own children represents an important hazard. Live attenuated varicella vaccine requires two doses to be adequately immunogenic in adults. Safety and clinical tolerability have been well documented, and persistent antibody protection from infection and virtual absence of early herpes zoster infections are inferred from encouraging preliminary data. 3 AUTHOR White CJ TITLE Clinical trials of varicella vaccine in healthy children. SOURCE Infect Dis Clin North Am; VOL 10, ISS 3, 1996, P595-608 (REF: 74) ABSTRACT The Oka varicella vaccine has been tested in clinical trials worldwide in thousands of children. Following licensure in Japan, Korea, Germany, and the United States, the vaccine has been used in several millions of children. The vaccine has been generally well-tolerated with the most common complaints being pain and redness at the injection site and a mild rash following vaccination. The incidence of herpes zoster has not increased in vaccinees and may have decreased. Efficacy rates vary between 65% and 100% depending on the intensity of exposure to natural varicella and the potency of the vaccine. In those few vaccinees who develop MVLS, the rash is generally milder than seen following natural infection (median < 50 versus 300 lesions, respectively, as well as a lower incidence of fever). There has been no evidence to date to indicate waning immunity postvaccination. Studies are in progress in the United States to evaluate whether this will occur and the effect of booster doses of vaccine. It is expected that in countries where there is widespread use of the vaccine in healthy children, disease rates will fall dramatically as will the morbidity and mortality associated with natural varicella in this population. 2 AUTHOR Gershon AA TITLE Live attenuated varicella vaccine. SOURCE Annu Rev Med; VOL 38, 1987, P41-50 (REF: 37) ABSTRACT Live attenuated varicella vaccine will in all probability soon be licensed in the United States for immunization of healthy children and adults and certain immunocompromised children. This vaccine can be expected to protect susceptibles from varicella (or to modify it) in those subsequently exposed to the wild virus. The vaccine is safe, immunogenic, and is not associated with an increase in the incidence of zoster. 9 AUTHOR Hong CY AUTHOR Goh LG TITLE Routine immunisation against chickenpox. Is it time? SOURCE J Singapore Paediatr Soc; VOL 34, ISS 1-2, 1992, P57-66 (REF: 55) ABSTRACT Natural varicella in healthy children is normally not a severe illness. Nevertheless, the need to be away from school such as during an important examination, or from work, may be inopportune. It is therefore attractive to be able to prevent chickenpox. Such a proposition became a reality in 1974 with the development of a live attenuated varicella vaccine (the Oka strain). This has since been used in leukaemic children and children with other malignancies, and found to be safe and effective. Some of these children were immunised without complete suspension of anticancer therapy. The vaccine has also been used on healthy children and adults, mainly in Japan and North America. The results too indicated the vaccine to be safe and immunogenic, with minimal side effects. It has been shown to confer protection even if given within 3 days of exposure. The occurrence of zoster appears to be no higher than in natural infection. The vaccine has so far been shown to be protective up to 10 years post-immunisation. It appears safe enough to offer the vaccine routinely to those who are at risk of infection. One dose of vaccine given subcutaneously is usually sufficient for healthy children, but two doses are needed for immunocompromised children and adults. 6 AUTHOR Watson BM AUTHOR Piercy SA AUTHOR Plotkin SA AUTHOR Starr SE TITLE Modified chickenpox in children immunized with the Oka/Merck varicella vaccine SOURCE Pediatrics; VOL 91 ISS Jan 1993, P17-22, (REF 22) ABSTRACT IPA COPYRIGHT: ASHP The severity of chickenpox was studied in 164 healthy children who were immunized with varicella vaccine at ages 1-7 yr. A total of 114 children had rashes consistent with chickenpox. When sera were available, antibody studies uniformly confirmed varicella-zoster virus infection. Chickenpox occurred 2-96 months after immunization. The number of skin lesions ranged from 1 to 285 in seroconverters and 54% were asymptomatic, except for the rash. Thirteen children in whom infections developed did not seroconvert after immunization. The rate of secondary chickenpox among immunized siblings was 12.2%. It was concluded that chickenpox is generally mild in previously immunized children.