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Persistence of Immunity to Varicella-Zoster Virus After Vaccination of Healthcare Workers

Published online by Cambridge University Press:  02 January 2015

Lisa Saiman ,
Philip LaRussa ,
Sharon P. Steinberg ,
Juyan Zhou ,
Keren Baron ,
Susan Whittier ,
Phyllis Della-Latta  and
Anne A. Gershon
Lisa Saiman*
Affiliation:
Departments of Pediatrics and Pathology, Columbia University, College of Physicians & Surgeons, New York City, New York
Philip LaRussa
Affiliation:
Departments of Pediatrics and Pathology, Columbia University, College of Physicians & Surgeons, New York City, New York
Sharon P. Steinberg
Affiliation:
Departments of Pediatrics and Pathology, Columbia University, College of Physicians & Surgeons, New York City, New York
Juyan Zhou
Affiliation:
Departments of Pediatrics and Pathology, Columbia University, College of Physicians & Surgeons, New York City, New York
Keren Baron
Affiliation:
Departments of Pediatrics and Pathology, Columbia University, College of Physicians & Surgeons, New York City, New York
Susan Whittier
Affiliation:
Departments of Pediatrics and Pathology, Columbia University, College of Physicians & Surgeons, New York City, New York
Phyllis Della-Latta
Affiliation:
Departments of Pediatrics and Pathology, Columbia University, College of Physicians & Surgeons, New York City, New York
Anne A. Gershon
Affiliation:
Departments of Pediatrics and Pathology, Columbia University, College of Physicians & Surgeons, New York City, New York
*
Columbia University, College of Physicians & Surgeons, 650 W 168th St, New York 10032
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Abstract

Objective:

Varicella-zoster virus (VZV) vaccine is recommended to protect susceptible healthcare workers (HCWs) from serious disease and to prevent nosocomial spread of VZV. We evaluated clinical outcomes and serological responses in HCWs after immunization with live attenuated VZV vaccine.

Design:

Vaccinees were immunized from 1979 to 1998 during VZV vaccine trials, as well as after licensure, and followed prospectively for 1 month to 20.6 (mean 4.6) years after vaccination. Sera were tested by fluorescent antibody to membrane antigen (FAMA), latex agglutination (LA), and enzyme-linked immunoassay (EIA) to detect VZV-specific antibodies.

Study Participants:

The median age of the 120 HCWs was 26 years; 51 (42%) were males.

Interventions:

Ninety eight (82%) of these study subjects received vaccine prepared by Merck and 22 (18%) by SmithKline Beecham; 25, 81, and 14 vaccinees received one dose, two doses, and three doses, respectively.

Results:

The crude attack rate was 10%; 12 of 120 HCWs developed chickenpox 6 months to 8.4 years after vaccination. The attack rates following household and hospital exposures were 18% (4/22) and 8% (6/72), respectively. All resulting illness was mild to moderate (mean 40 vesicles). Seroconversion after vaccination was documented by FAMA in 96% of HCWs, although 31% lost detectable antibodies. Compared with FAMA, LA and EIA were 82% and 74% sensitive and 94% and 89% specific, respectively.

Conclusions:

The VZV vaccine effectively protected HCWs from varicella, particularly from serious disease. Currently available serological tests are not optimal, and improved assays are needed.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 5 , May 2001 , pp. 279 - 283
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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References

1.Krasinski, K, Holzman, R, LaCoutre, R, Florman, A. Hospital experience with varicella-zoster virus. Infect Control 1986;7:312–316.CrossRefGoogle ScholarPubMed
2.Weber, DJ, Rutala, WA, Parham, C. Impact and costs of varicella prevention in a university hospital. Am J Public Health 1988;78:19–23.Google Scholar
3.Saiman, L, Crowley, K, Gershon, A. Control of varicella-zoster infections in hospitals. In: Abrutyn, E, Goldmann, DA, Scheckler, WE, eds. Infection Control Reference Service. Philadelphia, PA: WB Saunders Co; 1997:687–693.Google Scholar
4.Tennenberg, A, Brassard, JE, Van lieu, J, Drusin, L. Varicella vaccination for healthcare workers at a university hospital: an analysis of costs and benefits. Infect Control Hosp Epidemiol 1997;18:405–411.CrossRefGoogle Scholar
5.Immunization of health-care workers: recommendations of Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC). MMWR 1997;46:142.Google Scholar
6.Gershon, AA, Steinberg, SP, LaRussa, P, Ferrara, A, Hammerschlag, M, Gelb, L. Immunization of healthy adults with live attenuated varicella vaccine. J Infect Dis 1988;158:132–137.Google Scholar
7.Gershon, AA, Steinberg, SP, NIAID Collaborative Varicella Vaccine Study Group. Live attenuated varicella vaccine: protection in healthy adults in comparison to leukemic children. J Infect Dis 1990;161:661–666.Google Scholar
8.Zerboni, L, Nader, S, Aoki, K, Arvin, AM. Analysis of the persistence of humoral and cellular immunity in children and adults immunized with varicella vaccine. J Infect Dis 1998;177:1701–1704.CrossRefGoogle ScholarPubMed
9.Williams, V, Gershon, A, Brunell, P. Serologic response to varicella-zoster membrane antigens measured by indirect immunofluorescence. J Infect Dis 1974;130:669–672.Google Scholar
10.Gershon, A, Steinberg, S, LaRussa, P. Detection of antibodies to varicella-zoster virus by latex agglutination. Clinical Diagnostic Virology 1994;2:271–277.Google Scholar
11.Steinberg, SP, Gershon, AA. Measurement of antibodies to varicella-zoster virus by using a latex agglutination test. J Clin Microbiol 1991;29:1527–1529.Google Scholar
12.Hammerschlag, MR, Gershon, AA, Steinberg, SP, Clarke, L, Gelb, LD. Herpes zoster in an adult recipient of live attenuated varicella vaccine. J Infect Dis 1989;160:535–537.Google Scholar
13.Ross, AH. Modification of chickenpox in family contacts by administration of gamma globulin. N Engl J Med 1962;267:369–376.Google Scholar
14.Ndumbe, PM, MacQueen, S, Holzel, H, Davies, EG, Cradock-Watson, JE, Dunn, H, et al. Immunisation of nurses with a live varicella vaccine. Lancet 1985:1144–1147.Google Scholar
15.Oshiro, AC, Begue, RE, Steele, RW. Varicella disease and transmission in pediatric house officers. Pediatr Infect Dis J 1996;15:461–462.Google Scholar
16.Gershon, AA. Varicella-zoster virus: prospects for control. Advances in Pediatric Infectious Diseases 1995;10:93–124.Google ScholarPubMed
17.White, CJ. Varicella-zoster virus vaccine. Clin Infect Dis 1997;24:753–763.CrossRefGoogle ScholarPubMed
18.Johnson, CE, Stancin, T, Fattlar, D, Rome, LP, Kumar, ML. A long-term prospective study of varicella vaccine in healthy children. Pediatrics 1997;100:761–766.Google Scholar
19.Saiman, L, Weber, DJ. Implications of varicella in the healthcare setting. In: Arvin, A, Gershon, AA, eds. Varicella Zoster Virus. Cambridge, UK: Cambridge University Press; 2000:477–499.Google Scholar
20.Sharrar, R, LaRussa, P, Galea, S, Steinberg, S, Keatly, R, Wells, M, et al. An analysis of the first three months of reported adverse experiences associated with the administration of varicella vaccine. Vaccine 2000;19:915–923.Google Scholar
21.Provost, PJ, Krah, DL, Kuter, BJ, Morton, DH, Schofield, TL, Wasmuth, EH, et al. Antibody assays suitable for assessing immune responses to live varicella vaccine. Vaccine 1991;9:111–116.CrossRefGoogle ScholarPubMed