Varicella vaccination in children with chronic renal failure. A report of the Southwest Pediatric Nephrology Study Group

Susan L. Furth, Ronald J. Hogg, Joyce Tarver, Lawrence H. Moulton, Christina Chan, Barbara A. Fivush

Research output: Contribution to journalArticlepeer-review

Abstract

Children with kidney disease are at risk for serious varicella-related complications. To evaluate the safety and immunogenicity of a two-dose regimen of varicella vaccine in children (aged 1-19 years) with chronic renal insufficiency and on dialysis, the Southwest Pediatric Nephrology Study Group (SPNSG) undertook an open-label, multi-center, prospective 3-year clinical trial. Ninety-six patients without history of varicella were enrolled. Fifty (mean age 4.2 years) had no detectable varicella zoster virus (VZV) antibody; 98% sero-converted after the two-dose regimen. At 1, 2, and 3 years' follow-up, all patients studied maintained VZV antibody, including 16 who received a transplant. No significant vaccine-associated adverse events were seen. One subject developed mild varicella (10-50 maculopapular lesions) 16 monthis post transplant. In multivariate regression analysis, patients vaccinated after age 6 years had VZV antibody levels 73% (95% confidence interval 33%-89%) lower than patients vaccinated before age 6 years after controlling for gender, estimated glomerular filtration rate, and dialysis treatment. Adjusted analysis also showed that VZV antibody levels were lower after kidney transplantation, but this appeared to be a transient phenomenon. In this study, varicella vaccination with a two-dose regimen of varicella vaccine was generally well tolerated and highly immunogenic in children with chronic kidney disease.

Original languageEnglish (US)
Pages (from-to)33-38
Number of pages6
JournalPediatric Nephrology
Volume18
Issue number1
DOIs
StatePublished - Jan 1 2003

Keywords

  • End-stage renal disease
  • Immunization
  • Kidney disease
  • Transplant
  • Varicella

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

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