Live zoster vaccination in an immunocompromised patient leading to death secondary to disseminated varicella zoster virus infection

Live zoster vaccination in an immunocompromised patient leading to death secondary to disseminated varicella zoster virus infection.

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Item Type: Article
Status: Published
Official URL: https://doi.org/10.1016/j.vaccine.2018.05.078
Journal or Publication Title: Vaccine
Volume: 36
Number: 27
Page Range: pp. 3890-3893
Date: 2018
Divisions: Epigenetics and RNA Biology
Depositing User: General Admin
Identification Number: 10.1016/j.vaccine.2018.05.078
ISSN: 0264410X
Date Deposited: 03 Jan 2021 22:52
Abstract:

In 2016, the live attenuated zoster vaccine (Zostavax, Merck and Co, USA) was introduced into the Australian National Immunisation Program for people aged 70 years who are not significantly immunocompromised. We report the administration of Zostavax in an immunocompromised patient with chronic lymphocytic leukaemia and no evidence of primary varicella zoster virus (VZV) infection. The patient presented with a bilateral vesicular facial rash 22 days after receiving Zostavax and was initially managed as an outpatient with oral acyclovir. He re-presented three days later and was diagnosed with disseminated VZV infection complicated by meningoencephalitis. The patient died following cardiac arrest on day 10 of hospitalisation. This unfortunate case highlights the challenge of safely implementing a high titre live vaccine in a population where contraindications are prevalent. The non-live recombinant herpes zoster subunit vaccine (Shingrix, GSK) may provide a safe and effective option to protect immunocompromised patients from shingles and post-herpetic neuralgia.

Keywords: Immunosuppressed; Oka varicella zoster vaccine virus; Public health; Varicella zoster virus infection; Zostavax.

Copyright © 2018 Elsevier Ltd. All rights reserved.

Creators:
Creators
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Alexander, Kate E.
UNSPECIFIED
Tong, Philip L.
UNSPECIFIED
Macartney, Kristine
UNSPECIFIED
Beresford, Rohan
UNSPECIFIED
Sheppeard, Vicky
UNSPECIFIED
Gupta, Monisha
UNSPECIFIED
Last Modified: 03 Jan 2021 22:52
URI: https://eprints.centenary.org.au/id/eprint/512

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