Mollo A, Peri M, Lodi L, Gissi A, Lionetti P, Marrani E, Mastrolia M V, Tondo A, Tintori V, Sardi I, Indolfi G, Trapani S, Galli L, Venturini E, Astorino V, Azzari C, Ricci S
Department of Health Sciences, University of Florence, Florence, Italy.
Department of Health Sciences, University of Florence, Florence, Italy.
Vaccine. 2025 Apr 19;53:127072. doi: 10.1016/j.vaccine.2025.127072. Epub 2025 Apr 7.
A recombinant vaccine is approved to prevent herpes zoster (HZ) in adults ≥50 years and immunocompromised individuals ≥19 years. However, in children, the live attenuated vaccine remains the only prevention strategy against varicella zoster virus (VZV), with only one trial evaluating the safety and immunogenicity of GlaxoSmithKline's HZ subunit candidate vaccine in immunocompromised children.
To estimate VZV burden in our third level pediatric hospital and identify high-risk pediatric groups for its occurrence and complications to explore the need for an inactivated vaccine.
We reviewed VZV/HZ hospital discharge codes and positive VZV molecular tests at Meyer Children's Hospital from January 2018 to May 2023. We categorized patients based on their vaccination status as unvaccinated, partially vaccinated (single dose), or fully vaccinated (complete two-dose regimen). 96 controls from the same Departments and period were also included to assess VZV vaccine effectiveness.
Of 48 patients with VZV (52 % female; median age: 11.6 years [IQR: 7-14.2]), 10 had chickenpox and 38 HZ; 2/48 (4.2 %) received 2 doses of vaccination, 10/48 (20.8 %) were immunized with 1 dose and 36/48 (75 %) were unvaccinated. Immune-related comorbidities were present in 20/48 (42 %) patients, and among those with HZ requiring hospitalization, comorbidities strongly predicted admission (OR 4.71; 95 % CI, 1.23-20.39; p = 0.028). Full vaccination was more frequent in controls (43/96, 45 %) than in cases (2/48, 4.2 %; p < 0.001).
In our cohort, many cases had comorbidities contraindicating the live attenuated vaccine. If proven safe and effective, the recombinant HZ vaccine could offer a preventive option for immunocompromised children ineligible for live viral vaccines.
一种重组疫苗已获批准用于预防50岁及以上成人和19岁及以上免疫功能低下个体的带状疱疹（HZ）。然而，对于儿童，减毒活疫苗仍然是预防水痘带状疱疹病毒（VZV）的唯一策略，仅有一项试验评估了葛兰素史克公司的HZ亚单位候选疫苗在免疫功能低下儿童中的安全性和免疫原性。
评估我们三级儿童医院的VZV负担，确定其发生和并发症的高危儿科群体，以探讨是否需要一种灭活疫苗。
我们回顾了2018年1月至2023年5月迈耶儿童医院的VZV/HZ出院编码和VZV分子检测阳性结果。我们根据患者的疫苗接种状况将其分类为未接种、部分接种（单剂）或完全接种（完成两剂方案）。还纳入了同一科室和时期的96名对照者以评估VZV疫苗的有效性。
在48例VZV患者中（52%为女性；中位年龄：11.6岁[四分位间距：7 - 14.
