University of Texas Medical School at Houston, University of Texas Health, Houston, Texas, USA.
Curr Opin Infect Dis. 2012 Apr;25(2):135-40. doi: 10.1097/QCO.0b013e32834c1863.
Live attenuated vaccines exist for varicella and herpes zoster. Varicella vaccine is largely administered in the immunocompetent population despite substantial evidence indicating its safety and effectiveness in immunocompromised groups.
Varicella vaccine has been around for decades and its safety and efficacy in healthy children is well documented in the literature. The vaccine is contraindicated in the immunodeficient population. Recent studies have examined the immune response of varicella vaccine in children suffering from hematological malignancies, inflammatory bowel disease, human immunodeficiency virus with a CD4 T-cell count of at least 200 cell/μl, atopic dermatitis, and juvenile rheumatic diseases and found that the vaccine was immunogenic in most cases. In addition, the herpes zoster vaccine, which is the newest addition to the varicella vaccine family, has proven to be well tolerated and effective in healthy adults; however, the vaccination rate has been dismal.
Studies suggest that varicella vaccine is well tolerated and immunogenic in moderately immunocompromised children and could be beneficial in reducing the burden of viral infection. Similar studies in immunodeficient adults should be undertaken for herpes zoster vaccine, which has been shown to lower the incidence of herpes zoster and postherpetic neuralgia.
水痘和带状疱疹都有减毒活疫苗。尽管有大量证据表明减毒活疫苗在免疫功能低下人群中的安全性和有效性，但它主要在免疫功能正常人群中使用。
水痘疫苗已经问世几十年了，其在健康儿童中的安全性和有效性在文献中有充分记载。该疫苗不适用于免疫功能低下的人群。最近的研究检查了患有血液恶性肿瘤、炎症性肠病、人类免疫缺陷病毒（CD4 T 细胞计数至少为 200 个/μl）、特应性皮炎和青少年风湿性疾病的儿童对水痘疫苗的免疫反应，发现大多数情况下疫苗具有免疫原性。此外，带状疱疹疫苗是水痘疫苗家族中的最新成员，已被证明在健康成年人中耐受性良好且有效；然而，疫苗接种率一直很低。
研究表明，水痘疫苗在中度免疫功能低下的儿童中耐受性良好且具有免疫原性，可能有助于减轻病毒感染的负担。对于已证明可降低带状疱疹和带状疱疹后神经痛发病率的带状疱疹疫苗，应在免疫功能低下的成年人中进行类似的研究。
