Gershon A A, Steinberg S P, Gelb L, Galasso G, Borkowsky W, LaRussa P, Farrara A
JAMA. 1984 Jul 20;252(3):355-62. doi: 10.1001/jama.252.3.355.
One hundred ninety-one varicella-susceptible children with leukemia in remission were immunized with live attenuated varicella vaccine. There was serological evidence of an immune response in approximately 80% after one dose and in more than 90% after two doses. The major side effect was mild to moderate rash, seen especially in children with maintenance chemotherapy suspended for one week before and one week after vaccination. Children with rash had higher antibody titers than those without rash, but those with rash were also at risk (10%) to transmit vaccine virus to others. Twenty-two vaccinees subsequently had household exposures to varicella or zoster. The attack rate of clinical varicella in these vaccinees was 18%, significantly lower than the attack rate of approximately 90% in varicella-susceptible persons with household exposures. All cases of clinical illness were extremely mild, with an average of about 50 vesicles. The mild character of the illness was clearly different than varicella in unimmunized children receiving chemotherapy for leukemia. Varicella vaccine was approximately 80% effective in preventing clinical varicella in children with leukemia and completely effective in preventing severe varicella in this high-risk group.
191名处于缓解期的白血病水痘易感儿童接种了减毒活水痘疫苗。一剂疫苗接种后约80%的儿童有免疫反应的血清学证据，两剂疫苗接种后这一比例超过90%。主要副作用是轻度至中度皮疹，尤其见于在接种疫苗前一周和接种后一周暂停维持化疗的儿童。出疹儿童的抗体滴度高于未出疹儿童，但出疹儿童也有将疫苗病毒传播给他人的风险（10%）。随后有22名接种者在家中接触了水痘或带状疱疹。这些接种者中临床水痘的发病率为18%，显著低于有家庭接触史的水痘易感者约90%的发病率。所有临床疾病病例都极其轻微，平均约有50个水疱。这种疾病的轻微特征与接受白血病化疗的未接种疫苗儿童的水痘明显不同。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%，在预防这一高危人群的严重水痘方面完全有效。
