Gershon A A, Steinberg S, Gelb L, Galasso G, Borkowsky W, LaRussa P, Ferrara A
Postgrad Med J. 1985;61 Suppl 4:73-8.
Two hundred forty children with acute leukaemia in remission for at least 1 year were immunized with live attenuated varicella vaccine. All were susceptible to varicella before immunization. There was a seroconversion to varicella-zoster virus in approximately 85% after 1 dose, and in 97% after 2 doses. The major side effect was mild to moderate rash, seen mainly in children with maintenance chemotherapy suspended for 1 week before and 1 week after vaccination. Vaccinees with rash were at some risk (10%) to transmit vaccine virus to varicella susceptibles with whom they had close contact. Twenty-nine vaccinees were subsequently exposed to varicella in their households. The attack rate of clinical varicella in these vaccinees was 21%, which is significantly lower than the 80%-90% attack rate occurring in varicella susceptibles after household exposure. All these breakthrough cases of varicella were mild, even in leukaemics receiving chemotherapy. Varicella vaccine was approximately 80% effective in preventing clinical varicella in children with leukaemia and completely effective in preventing severe varicella in this high-risk group.
240名急性白血病缓解至少1年的儿童接种了减毒活水痘疫苗。所有儿童在接种前均对水痘易感。接种1剂后约85%的儿童出现水痘-带状疱疹病毒血清转化，接种2剂后97%的儿童出现血清转化。主要副作用为轻度至中度皮疹，主要见于在接种前1周和接种后1周暂停维持化疗的儿童。出现皮疹的接种者有一定风险（10%）将疫苗病毒传播给与其密切接触的水痘易感者。29名接种者随后在家庭中接触了水痘。这些接种者中临床水痘的发病率为21%，显著低于家庭接触后水痘易感者80%-90%的发病率。所有这些水痘突破性病例均较轻微，即使是接受化疗的白血病患者。水痘疫苗在预防白血病儿童临床水痘方面的有效性约为80%，在预防该高危人群严重水痘方面完全有效。
