Diaz P S, Au D, Smith S, Amylon M, Link M, Smith S, Arvin A M
Department of Pediatrics, Stanford University School of Medicine, California 94305.
Pediatrics. 1991 Feb;87(2):166-70.
The safety of administering the live attenuated Oka/Merck varicella vaccine to the well siblings of children with malignancy was evaluated as a strategy for reducing the risk of household exposure to varicella among immunocompromised children. Susceptible well children were eligible for vaccination if the child with malignancy had leukemia, lymphoma, or solid tumor in remission for 3 months or longer. No evidence of vaccine virus transmission was found among 30 children with malignancy whose 37 healthy susceptible siblings were immunized with varicella vaccine. Varicella-zoster virus was not isolated from the oropharyngeal secretions taken from 17 vaccinees or their 14 immunocompromised siblings. None of the 30 immunocompromised children had vaccine-related rashes or showed immunologic evidence of subclinical varicella-zoster virus infection based on testing for varicella-zoster virus IgG antibodies and T-lymphocyte proliferation to varicella-zoster virus. Four healthy vaccinees eventually had mild breakthrough cases of varicella, with transmission to the high-risk sibling in 3 cases. However, even in these families, the immunocompromised children had been protected from household exposure varicella for at least 20 months early in the course of their immunosuppressive treatment.
将减毒活Oka/默克水痘疫苗接种于恶性肿瘤患儿的健康同胞，以此作为降低免疫功能低下儿童家庭接触水痘风险的一种策略，其安全性得到了评估。如果患有恶性肿瘤的儿童患有白血病、淋巴瘤或实体瘤且缓解3个月或更长时间，其易感的健康儿童就有资格接种疫苗。在30名患有恶性肿瘤的儿童中，其37名健康易感同胞接种了水痘疫苗，未发现疫苗病毒传播的证据。从17名接种疫苗者及其14名免疫功能低下的同胞采集的口咽分泌物中未分离出水痘-带状疱疹病毒。30名免疫功能低下的儿童中，没有一人出现与疫苗相关的皮疹，也没有基于水痘-带状疱疹病毒IgG抗体检测和针对水痘-带状疱疹病毒的T淋巴细胞增殖检测显示亚临床水痘-带状疱疹病毒感染的免疫学证据。4名健康的接种疫苗者最终出现了轻度水痘突破病例，其中3例传播给了高危同胞。然而，即使在这些家庭中，免疫功能低下的儿童在免疫抑制治疗早期至少20个月内也受到了保护，未发生家庭接触水痘的情况。
